OBJECTIVE: To evaluate the current clinical use and utility of chest radiographs (CXR) in the workup of pediatric @entity1 with @entity13350 ( @entity13350 ) episodes. SETTING: Urban @entity1 's hospital. DESIGN: Retrospective review of medical records of @entity1 seen in the emergency department in 1994 with disposition diagnoses of @entity565 or reactive airways disease, @entity5924 , @entity55 , @entity299 , @entity712 , or foreign body aspiration to identify those @entity1 presenting with @entity13350 episodes. METHODS: Clinical findings in @entity13350 were compared in @entity1 receiving a CXR (121, 41%) and those who did not (177, 59%). Comparisons were made between @entity1 with a clinically significant CXR (CXR-pos) (29, 24%) and those without (92, 76%). CXR-pos was defined as a CXR result which would be expected to alter @entity1 management. Comparisons between groups were analyzed using the two-tailed Student's t test for continuous variables and the chi2 statistic for categorical data. The level of significance was determined at P < 0.05. RESULTS: Two hundred ninety-eight episodes of @entity13350 were identified of 1984 @entity1 charts reviewed. @entity1 receiving CXR differed from those who did not by being of a greater age (39 vs 20 months, P < 0.01), having lower pulse oximetry (89.7 vs. 92.7%, P < 0.01), being less likely to have a family history of @entity565 (47.5 vs 63.2%, P < 0.01), or history of atopy (40.6 vs 59.4%, P < 0.01). Those with localized wheezes (59.4 vs 40.6% P < 0.01), localized rales (59.3 vs 40.7 % P < 0.01), and localized decreased breath sounds (59.3 vs 40.7%, P = 0.01) were also more likely to receive a CXR. Among @entity1 receiving CXR, clinical characteristics associated with CXR-pos were elevated temperature (37.9 vs 37.5 degrees C, P = 0.04), absence of family history of @entity565 72.6 vs 27.4%, P < 0.01), and the presence of localized wheezes (76.0 vs 24.0%, P = 0.02), or localized rales (76.0 vs 24.0%, P < 0.01). CONCLUSIONS: Clinicians in this setting do not routinely obtain a CXR in @entity1 with @entity13350 episodes. Retrospective examination of clinician practice revealed several clinical characteristics that were associated with increased use of CXR in @entity13350 . Increased utility of the CXR was associated with @entity1 having elevated temperature, an absence of a family history of @entity565 , and localized wheezes or rales by ausculatory examination.

Chest radiograph in the evaluation of XXXX episodes: review of current clinical practice and efficacy.

@entity1 :: ('9606', 'Species') :: ['children', 'Patients', 'patients', 'patient'] @entity13350 :: ('MESH:D012135', 'Disease') :: ['first time wheezing', 'FTW'] @entity712 :: ('MESH:D006333', 'Disease') :: ['congestive heart failure'] @entity55 :: ('MESH:D011014', 'Disease') :: ['pneumonia'] @entity565 :: ('MESH:D001249', 'Disease') :: ['asthma'] @entity5924 :: ('MESH:D001988', 'Disease') :: ['bronchiolitis'] @entity299 :: ('MESH:D006331', 'Disease') :: ['congenital heart disease']
@entity13350 :: (MESH:D012135,Disease) :: ['first time wheezing']
