Predictors of a normal chest x-ray in respiratory syncytial virus infection

Citation
Mcj. Kneyber et al., Predictors of a normal chest x-ray in respiratory syncytial virus infection, PEDIAT PULM, 31(4), 2001, pp. 277-283
Citations number
28
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pediatrics
Journal title
PEDIATRIC PULMONOLOGY
ISSN journal
8755-6863 → ACNP
Volume
31
Issue
4
Year of publication
2001
Pages
277 - 283
Database
ISI
SICI code
8755-6863(200104)31:4<277:POANCX>2.0.ZU;2-S
Abstract
Respiratory syncytial virus (RSV) accounts for the majority of lower respir atory tract infections (LRTI) in infants and young children. A chest x-ray is frequently performed in infants with LRTI caused by RSV. The aim of this study was to develop and validate a prediction model to estimate the proba bility for a normal chest x-ray in children with RSV infection. For this pu rpose, easy obtainable diagnostic parameters were used. This prediction mod el may be applied to decide which patients do not require a chest x-ray. Th e data of 287 children admitted with RSV infection or diagnosed as such in the outpatient department of the Sophia Children's Hospital between 1992-19 96 were studied. The derivation set comprised 232 patients (1992-1995), and the validation set contained 55 patients (1995-1996). A chest x-ray was de signated as normal when atelectasis, hyperinflation, or pulmonary infiltrat es were absent. In order to develop a prediction model, patient history and clinical and laboratory variables were consecutively entered into a logist ic regression model according to the diagnostic workup that was practiced a t the time. Variables with P less than or equal to 0.10 were retained in th e model. The predictive accuracy of the multivariable models was examined u sing the area under receiver operating curve (ROC-area). In 202 (87%) patients from the derivation set, a chest x-ray was performed, A normal chest xray could be predicted by increasing age, increasing birth weight, presence of rhinitis, absence of retractions, and increasing arter ial oxygen saturation. The ROC-area was 0.80 in the derivation and validati on sets. This prediction model was transformed into a score chart. In conclusion, a normal chest x-ray can accurately be predicted, using a mo del including easily obtainable patient characteristics, and clinical and l aboratory variables. This model may be useful tool in deciding whether or n ot to perform a chest x-ray in patients with RSV infections. (C) 2001 Wiley -Liss.