Respiratory morbidity in central Australian Aboriginal children with alveolar lobar abnormalities.
OBJECTIVE
To describe the short-term outcomes in Aboriginal children admitted to hospital with radiological alveolar lobar changes; and determine whether predischarge chest radiography can predict respiratory morbidity found at follow-up. DESIGN, PARTICIPANTS, SETTING: Prospective cohort study of Aboriginal children admitted to Alice Springs Hospital between October 2000 and April 2001 with alveolar lobar abnormalities (area of consolidation, > or = 1 cm) on chest radiographs. Participants were to have a predischarge radiograph and be followed up for 12 months.


METHODS
Comorbidities, follow-up rate, and new respiratory disease found at follow-up.


RESULTS
Of 113 children hospitalised with radiological alveolar lobar changes, 109 were Aboriginal. Their median age was 1.8 years (range, 0.2 months-13.3 years), and 124 episodes were recorded. Comorbidities were common in these children (anaemia, 51.5%; suppurative otitis media, 37.3%). The follow-up rate one year after admission was 83.1% of episodes. New treatable chronic respiratory morbidity was found in 20 (25.6%) of the 78 children with completed follow-up. Predischarge chest radiographs were predictive of all chronic respiratory morbidity when they showed no or minimal resolution (0-20% resolution) (relative risk, 7.43; 95% CI, 2.07-26.60).


CONCLUSIONS
Central Australian Aboriginal children admitted to hospital with alveolar changes on chest radiographs have a substantial burden of chronic respiratory illness, and should be clinically followed up for early detection and management of chronic respiratory morbidity. A predischarge radiograph is useful, and patients whose radiograph shows no or minimal resolution should have a follow-up x-ray film.
Department of Respiratory Medicine, Royal Children's Hospital, Herston Road, Herston, QLD 4006, Australia. annechang@ausdoctors.net
Anne B
AB
Chang
John P
JP
Masel
Naomi C
NC
Boyce
Paul J
PJ
Torzillo
D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D006801:Humans; D007223:Infant; D010351:Patient Discharge; D011014:Pneumonia / Q000000981:diagnostic imaging* / Q000208:ethnology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011650:Pulmonary Alveoli / Q000000981:diagnostic imaging*; D011859:Radiography; D012140:Respiratory Tract Diseases / Q000000981:diagnostic imaging / Q000208:ethnology*; D018709:Statistics, Nonparametric; D000095283:Australian Aboriginal and Torres Strait Islander Peoples