Can chest X-ray predict pneumonia severity?
Predictors of the severity of pneumonia have not been thoroughly evaluated among children in developed countries. We investigate whether chest radiographic findings could be used as predictors of severity of childhood pneumonia. The study included 167 children, aged more than 12 months, hospitalized in our department during a 4-year period with unilateral lobar or segmental pneumonia. The durations of fever and of hospitalization were considered indicators of severity of the disease. The size of the consolidation and its location in the left hemithorax were independently associated with severity of the disease. Univariate analysis showed that the mean duration of fever and of hospitalization as well as the prevalence of pleural effusion was significantly higher among children with left-sided pneumonia. A multiple logistic regression analysis revealed that only the presence of pleural effusion was significantly more likely in left-sided pneumonia (odds ratio, 2.65; 95% confidence interval, 1.09-6.47; P = 0.031). We conclude that the size of consolidation and the side of its location can be used as predictors of severity of pneumonia, with left-sided pneumonia running a more severe course, possibly due to increased risk for the development of pleurisy.
Grafakou
Olga
O
Second Department of Pediatrics, University of Athens, P. and A. Kyriakou Children's Hospital, Athens, Greece. grafakou@hol.gr
Moustaki
Maria
M
Tsolia
Maria
M
Kavazarakis
Emmanuel
E
Mathioudakis
John
J
Fretzayas
Andrew
A
Nicolaidou
Polyxeni
P
Karpathios
Themistokles
T
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D010996:Pleural Effusion / Q000209:etiology; D011014:Pneumonia / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
D000900:Anti-Bacterial Agents