Differences upon admission and in hospital course of children hospitalized with community-acquired pneumonia with or without radiologically-confirmed pneumonia: a retrospective cohort study
Background The use of chest radiograph (CXR) for the diagnosis of childhood community-acquired pneumonia (CAP) is controversial. We assessed if children with CAP diagnosed on clinical grounds, with or without radiologically-confirmed pneumonia on admission, evolved differently. Methods Children aged...
Ausführliche Beschreibung
Autor*in: |
Simbalista, Raquel [verfasserIn] |
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E-Artikel |
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Englisch |
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2015 |
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Anmerkung: |
© Simbalista et al. 2015 |
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Übergeordnetes Werk: |
Enthalten in: BMC pediatrics - London : BioMed Central, 2001, 15(2015), 1 vom: 23. Okt. |
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Übergeordnetes Werk: |
volume:15 ; year:2015 ; number:1 ; day:23 ; month:10 |
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DOI / URN: |
10.1186/s12887-015-0485-6 |
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Katalog-ID: |
SPR027760626 |
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520 | |a Background The use of chest radiograph (CXR) for the diagnosis of childhood community-acquired pneumonia (CAP) is controversial. We assessed if children with CAP diagnosed on clinical grounds, with or without radiologically-confirmed pneumonia on admission, evolved differently. Methods Children aged ≥ 2 months, hospitalized with CAP diagnosed on clinical grounds, treated with 200,000 IU/Kg/day of aqueous penicillin G for ≥ 48 h and with CXR taken upon admission, without pleural effusion, were included in this retrospective cohort. One researcher, blinded to the radiological diagnosis, collected data on demographics, clinical history and physical examination on admission, daily hospital course during the first 2 days of treatment, and outcome, all from medical charts. Radiological confirmation of pneumonia was based on presence of pulmonary infiltrate detected by a paediatric radiologist who was also blinded to clinical data. Variables were initially compared by bivariate analysis. Multi-variable logistic regression analysis assessed independent association between radiologically-confirmed pneumonia and factors which significantly differed during hospital course in the bivariate analysis. The multi-variable analysis was performed in a model adjusted for age and for the same factor present upon admission. Results 109 (38.5 %) children had radiologically-confirmed pneumonia, 143 (50.5 %) had normal CXR and 31 (11.0 %) had atelectasis or peribronchial thickening. Children without radiologically-confirmed pneumonia were younger than those with radiologically-confirmed pneumonia (median [IQR]: 14 [7–28 months versus 21 [12–44] months; P = 0.001). None died. The subgroup with radiologically-confirmed pneumonia presented fever on D1 (33.7 vs. 19.1; P = 0.015) and on D2 (31.6 % vs. 16.2 %; P = 0.004) more frequently. The subgroup without radiologically-confirmed pneumonia had chest indrawing on D1 (22.4 % vs. 11.9 %; P = 0.027) more often detected. By multi-variable analysis, Fever on D2 (OR [95 % CI]: 2.16 [1.15-4.06]) was directly and independently associated with radiologically-confirmed pneumonia upon admission. Conclusion The compared subgroups evolved differently. | ||
650 | 4 | |a Community Acquire Pneumonia |7 (dpeaa)DE-He213 | |
650 | 4 | |a Pulmonary Infiltrate |7 (dpeaa)DE-He213 | |
650 | 4 | |a Radiological Diagnosis |7 (dpeaa)DE-He213 | |
650 | 4 | |a Acute Lower Respiratory Tract Infection |7 (dpeaa)DE-He213 | |
650 | 4 | |a Severe Community Acquire Pneumonia |7 (dpeaa)DE-He213 | |
700 | 1 | |a Andrade, Dafne C. |4 aut | |
700 | 1 | |a Borges, Igor C. |4 aut | |
700 | 1 | |a Araújo, Marcelo |4 aut | |
700 | 1 | |a Nascimento-Carvalho, Cristiana M. |4 aut | |
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10.1186/s12887-015-0485-6 doi (DE-627)SPR027760626 (SPR)s12887-015-0485-6-e DE-627 ger DE-627 rakwb eng Simbalista, Raquel verfasserin aut Differences upon admission and in hospital course of children hospitalized with community-acquired pneumonia with or without radiologically-confirmed pneumonia: a retrospective cohort study 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Simbalista et al. 2015 Background The use of chest radiograph (CXR) for the diagnosis of childhood community-acquired pneumonia (CAP) is controversial. We assessed if children with CAP diagnosed on clinical grounds, with or without radiologically-confirmed pneumonia on admission, evolved differently. Methods Children aged ≥ 2 months, hospitalized with CAP diagnosed on clinical grounds, treated with 200,000 IU/Kg/day of aqueous penicillin G for ≥ 48 h and with CXR taken upon admission, without pleural effusion, were included in this retrospective cohort. One researcher, blinded to the radiological diagnosis, collected data on demographics, clinical history and physical examination on admission, daily hospital course during the first 2 days of treatment, and outcome, all from medical charts. Radiological confirmation of pneumonia was based on presence of pulmonary infiltrate detected by a paediatric radiologist who was also blinded to clinical data. Variables were initially compared by bivariate analysis. Multi-variable logistic regression analysis assessed independent association between radiologically-confirmed pneumonia and factors which significantly differed during hospital course in the bivariate analysis. The multi-variable analysis was performed in a model adjusted for age and for the same factor present upon admission. Results 109 (38.5 %) children had radiologically-confirmed pneumonia, 143 (50.5 %) had normal CXR and 31 (11.0 %) had atelectasis or peribronchial thickening. Children without radiologically-confirmed pneumonia were younger than those with radiologically-confirmed pneumonia (median [IQR]: 14 [7–28 months versus 21 [12–44] months; P = 0.001). None died. The subgroup with radiologically-confirmed pneumonia presented fever on D1 (33.7 vs. 19.1; P = 0.015) and on D2 (31.6 % vs. 16.2 %; P = 0.004) more frequently. The subgroup without radiologically-confirmed pneumonia had chest indrawing on D1 (22.4 % vs. 11.9 %; P = 0.027) more often detected. By multi-variable analysis, Fever on D2 (OR [95 % CI]: 2.16 [1.15-4.06]) was directly and independently associated with radiologically-confirmed pneumonia upon admission. Conclusion The compared subgroups evolved differently. Community Acquire Pneumonia (dpeaa)DE-He213 Pulmonary Infiltrate (dpeaa)DE-He213 Radiological Diagnosis (dpeaa)DE-He213 Acute Lower Respiratory Tract Infection (dpeaa)DE-He213 Severe Community Acquire Pneumonia (dpeaa)DE-He213 Andrade, Dafne C. aut Borges, Igor C. aut Araújo, Marcelo aut Nascimento-Carvalho, Cristiana M. aut Enthalten in BMC pediatrics London : BioMed Central, 2001 15(2015), 1 vom: 23. Okt. (DE-627)326643621 (DE-600)2041342-7 1471-2431 nnns volume:15 year:2015 number:1 day:23 month:10 https://dx.doi.org/10.1186/s12887-015-0485-6 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2015 1 23 10 |
spelling |
10.1186/s12887-015-0485-6 doi (DE-627)SPR027760626 (SPR)s12887-015-0485-6-e DE-627 ger DE-627 rakwb eng Simbalista, Raquel verfasserin aut Differences upon admission and in hospital course of children hospitalized with community-acquired pneumonia with or without radiologically-confirmed pneumonia: a retrospective cohort study 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Simbalista et al. 2015 Background The use of chest radiograph (CXR) for the diagnosis of childhood community-acquired pneumonia (CAP) is controversial. We assessed if children with CAP diagnosed on clinical grounds, with or without radiologically-confirmed pneumonia on admission, evolved differently. Methods Children aged ≥ 2 months, hospitalized with CAP diagnosed on clinical grounds, treated with 200,000 IU/Kg/day of aqueous penicillin G for ≥ 48 h and with CXR taken upon admission, without pleural effusion, were included in this retrospective cohort. One researcher, blinded to the radiological diagnosis, collected data on demographics, clinical history and physical examination on admission, daily hospital course during the first 2 days of treatment, and outcome, all from medical charts. Radiological confirmation of pneumonia was based on presence of pulmonary infiltrate detected by a paediatric radiologist who was also blinded to clinical data. Variables were initially compared by bivariate analysis. Multi-variable logistic regression analysis assessed independent association between radiologically-confirmed pneumonia and factors which significantly differed during hospital course in the bivariate analysis. The multi-variable analysis was performed in a model adjusted for age and for the same factor present upon admission. Results 109 (38.5 %) children had radiologically-confirmed pneumonia, 143 (50.5 %) had normal CXR and 31 (11.0 %) had atelectasis or peribronchial thickening. Children without radiologically-confirmed pneumonia were younger than those with radiologically-confirmed pneumonia (median [IQR]: 14 [7–28 months versus 21 [12–44] months; P = 0.001). None died. The subgroup with radiologically-confirmed pneumonia presented fever on D1 (33.7 vs. 19.1; P = 0.015) and on D2 (31.6 % vs. 16.2 %; P = 0.004) more frequently. The subgroup without radiologically-confirmed pneumonia had chest indrawing on D1 (22.4 % vs. 11.9 %; P = 0.027) more often detected. By multi-variable analysis, Fever on D2 (OR [95 % CI]: 2.16 [1.15-4.06]) was directly and independently associated with radiologically-confirmed pneumonia upon admission. Conclusion The compared subgroups evolved differently. Community Acquire Pneumonia (dpeaa)DE-He213 Pulmonary Infiltrate (dpeaa)DE-He213 Radiological Diagnosis (dpeaa)DE-He213 Acute Lower Respiratory Tract Infection (dpeaa)DE-He213 Severe Community Acquire Pneumonia (dpeaa)DE-He213 Andrade, Dafne C. aut Borges, Igor C. aut Araújo, Marcelo aut Nascimento-Carvalho, Cristiana M. aut Enthalten in BMC pediatrics London : BioMed Central, 2001 15(2015), 1 vom: 23. Okt. (DE-627)326643621 (DE-600)2041342-7 1471-2431 nnns volume:15 year:2015 number:1 day:23 month:10 https://dx.doi.org/10.1186/s12887-015-0485-6 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2015 1 23 10 |
allfields_unstemmed |
10.1186/s12887-015-0485-6 doi (DE-627)SPR027760626 (SPR)s12887-015-0485-6-e DE-627 ger DE-627 rakwb eng Simbalista, Raquel verfasserin aut Differences upon admission and in hospital course of children hospitalized with community-acquired pneumonia with or without radiologically-confirmed pneumonia: a retrospective cohort study 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Simbalista et al. 2015 Background The use of chest radiograph (CXR) for the diagnosis of childhood community-acquired pneumonia (CAP) is controversial. We assessed if children with CAP diagnosed on clinical grounds, with or without radiologically-confirmed pneumonia on admission, evolved differently. Methods Children aged ≥ 2 months, hospitalized with CAP diagnosed on clinical grounds, treated with 200,000 IU/Kg/day of aqueous penicillin G for ≥ 48 h and with CXR taken upon admission, without pleural effusion, were included in this retrospective cohort. One researcher, blinded to the radiological diagnosis, collected data on demographics, clinical history and physical examination on admission, daily hospital course during the first 2 days of treatment, and outcome, all from medical charts. Radiological confirmation of pneumonia was based on presence of pulmonary infiltrate detected by a paediatric radiologist who was also blinded to clinical data. Variables were initially compared by bivariate analysis. Multi-variable logistic regression analysis assessed independent association between radiologically-confirmed pneumonia and factors which significantly differed during hospital course in the bivariate analysis. The multi-variable analysis was performed in a model adjusted for age and for the same factor present upon admission. Results 109 (38.5 %) children had radiologically-confirmed pneumonia, 143 (50.5 %) had normal CXR and 31 (11.0 %) had atelectasis or peribronchial thickening. Children without radiologically-confirmed pneumonia were younger than those with radiologically-confirmed pneumonia (median [IQR]: 14 [7–28 months versus 21 [12–44] months; P = 0.001). None died. The subgroup with radiologically-confirmed pneumonia presented fever on D1 (33.7 vs. 19.1; P = 0.015) and on D2 (31.6 % vs. 16.2 %; P = 0.004) more frequently. The subgroup without radiologically-confirmed pneumonia had chest indrawing on D1 (22.4 % vs. 11.9 %; P = 0.027) more often detected. By multi-variable analysis, Fever on D2 (OR [95 % CI]: 2.16 [1.15-4.06]) was directly and independently associated with radiologically-confirmed pneumonia upon admission. Conclusion The compared subgroups evolved differently. Community Acquire Pneumonia (dpeaa)DE-He213 Pulmonary Infiltrate (dpeaa)DE-He213 Radiological Diagnosis (dpeaa)DE-He213 Acute Lower Respiratory Tract Infection (dpeaa)DE-He213 Severe Community Acquire Pneumonia (dpeaa)DE-He213 Andrade, Dafne C. aut Borges, Igor C. aut Araújo, Marcelo aut Nascimento-Carvalho, Cristiana M. aut Enthalten in BMC pediatrics London : BioMed Central, 2001 15(2015), 1 vom: 23. Okt. (DE-627)326643621 (DE-600)2041342-7 1471-2431 nnns volume:15 year:2015 number:1 day:23 month:10 https://dx.doi.org/10.1186/s12887-015-0485-6 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2015 1 23 10 |
allfieldsGer |
10.1186/s12887-015-0485-6 doi (DE-627)SPR027760626 (SPR)s12887-015-0485-6-e DE-627 ger DE-627 rakwb eng Simbalista, Raquel verfasserin aut Differences upon admission and in hospital course of children hospitalized with community-acquired pneumonia with or without radiologically-confirmed pneumonia: a retrospective cohort study 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Simbalista et al. 2015 Background The use of chest radiograph (CXR) for the diagnosis of childhood community-acquired pneumonia (CAP) is controversial. We assessed if children with CAP diagnosed on clinical grounds, with or without radiologically-confirmed pneumonia on admission, evolved differently. Methods Children aged ≥ 2 months, hospitalized with CAP diagnosed on clinical grounds, treated with 200,000 IU/Kg/day of aqueous penicillin G for ≥ 48 h and with CXR taken upon admission, without pleural effusion, were included in this retrospective cohort. One researcher, blinded to the radiological diagnosis, collected data on demographics, clinical history and physical examination on admission, daily hospital course during the first 2 days of treatment, and outcome, all from medical charts. Radiological confirmation of pneumonia was based on presence of pulmonary infiltrate detected by a paediatric radiologist who was also blinded to clinical data. Variables were initially compared by bivariate analysis. Multi-variable logistic regression analysis assessed independent association between radiologically-confirmed pneumonia and factors which significantly differed during hospital course in the bivariate analysis. The multi-variable analysis was performed in a model adjusted for age and for the same factor present upon admission. Results 109 (38.5 %) children had radiologically-confirmed pneumonia, 143 (50.5 %) had normal CXR and 31 (11.0 %) had atelectasis or peribronchial thickening. Children without radiologically-confirmed pneumonia were younger than those with radiologically-confirmed pneumonia (median [IQR]: 14 [7–28 months versus 21 [12–44] months; P = 0.001). None died. The subgroup with radiologically-confirmed pneumonia presented fever on D1 (33.7 vs. 19.1; P = 0.015) and on D2 (31.6 % vs. 16.2 %; P = 0.004) more frequently. The subgroup without radiologically-confirmed pneumonia had chest indrawing on D1 (22.4 % vs. 11.9 %; P = 0.027) more often detected. By multi-variable analysis, Fever on D2 (OR [95 % CI]: 2.16 [1.15-4.06]) was directly and independently associated with radiologically-confirmed pneumonia upon admission. Conclusion The compared subgroups evolved differently. Community Acquire Pneumonia (dpeaa)DE-He213 Pulmonary Infiltrate (dpeaa)DE-He213 Radiological Diagnosis (dpeaa)DE-He213 Acute Lower Respiratory Tract Infection (dpeaa)DE-He213 Severe Community Acquire Pneumonia (dpeaa)DE-He213 Andrade, Dafne C. aut Borges, Igor C. aut Araújo, Marcelo aut Nascimento-Carvalho, Cristiana M. aut Enthalten in BMC pediatrics London : BioMed Central, 2001 15(2015), 1 vom: 23. Okt. (DE-627)326643621 (DE-600)2041342-7 1471-2431 nnns volume:15 year:2015 number:1 day:23 month:10 https://dx.doi.org/10.1186/s12887-015-0485-6 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2015 1 23 10 |
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10.1186/s12887-015-0485-6 doi (DE-627)SPR027760626 (SPR)s12887-015-0485-6-e DE-627 ger DE-627 rakwb eng Simbalista, Raquel verfasserin aut Differences upon admission and in hospital course of children hospitalized with community-acquired pneumonia with or without radiologically-confirmed pneumonia: a retrospective cohort study 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Simbalista et al. 2015 Background The use of chest radiograph (CXR) for the diagnosis of childhood community-acquired pneumonia (CAP) is controversial. We assessed if children with CAP diagnosed on clinical grounds, with or without radiologically-confirmed pneumonia on admission, evolved differently. Methods Children aged ≥ 2 months, hospitalized with CAP diagnosed on clinical grounds, treated with 200,000 IU/Kg/day of aqueous penicillin G for ≥ 48 h and with CXR taken upon admission, without pleural effusion, were included in this retrospective cohort. One researcher, blinded to the radiological diagnosis, collected data on demographics, clinical history and physical examination on admission, daily hospital course during the first 2 days of treatment, and outcome, all from medical charts. Radiological confirmation of pneumonia was based on presence of pulmonary infiltrate detected by a paediatric radiologist who was also blinded to clinical data. Variables were initially compared by bivariate analysis. Multi-variable logistic regression analysis assessed independent association between radiologically-confirmed pneumonia and factors which significantly differed during hospital course in the bivariate analysis. The multi-variable analysis was performed in a model adjusted for age and for the same factor present upon admission. Results 109 (38.5 %) children had radiologically-confirmed pneumonia, 143 (50.5 %) had normal CXR and 31 (11.0 %) had atelectasis or peribronchial thickening. Children without radiologically-confirmed pneumonia were younger than those with radiologically-confirmed pneumonia (median [IQR]: 14 [7–28 months versus 21 [12–44] months; P = 0.001). None died. The subgroup with radiologically-confirmed pneumonia presented fever on D1 (33.7 vs. 19.1; P = 0.015) and on D2 (31.6 % vs. 16.2 %; P = 0.004) more frequently. The subgroup without radiologically-confirmed pneumonia had chest indrawing on D1 (22.4 % vs. 11.9 %; P = 0.027) more often detected. By multi-variable analysis, Fever on D2 (OR [95 % CI]: 2.16 [1.15-4.06]) was directly and independently associated with radiologically-confirmed pneumonia upon admission. Conclusion The compared subgroups evolved differently. Community Acquire Pneumonia (dpeaa)DE-He213 Pulmonary Infiltrate (dpeaa)DE-He213 Radiological Diagnosis (dpeaa)DE-He213 Acute Lower Respiratory Tract Infection (dpeaa)DE-He213 Severe Community Acquire Pneumonia (dpeaa)DE-He213 Andrade, Dafne C. aut Borges, Igor C. aut Araújo, Marcelo aut Nascimento-Carvalho, Cristiana M. aut Enthalten in BMC pediatrics London : BioMed Central, 2001 15(2015), 1 vom: 23. Okt. (DE-627)326643621 (DE-600)2041342-7 1471-2431 nnns volume:15 year:2015 number:1 day:23 month:10 https://dx.doi.org/10.1186/s12887-015-0485-6 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2015 1 23 10 |
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Simbalista, Raquel |
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Simbalista, Raquel misc Community Acquire Pneumonia misc Pulmonary Infiltrate misc Radiological Diagnosis misc Acute Lower Respiratory Tract Infection misc Severe Community Acquire Pneumonia Differences upon admission and in hospital course of children hospitalized with community-acquired pneumonia with or without radiologically-confirmed pneumonia: a retrospective cohort study |
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Differences upon admission and in hospital course of children hospitalized with community-acquired pneumonia with or without radiologically-confirmed pneumonia: a retrospective cohort study Community Acquire Pneumonia (dpeaa)DE-He213 Pulmonary Infiltrate (dpeaa)DE-He213 Radiological Diagnosis (dpeaa)DE-He213 Acute Lower Respiratory Tract Infection (dpeaa)DE-He213 Severe Community Acquire Pneumonia (dpeaa)DE-He213 |
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differences upon admission and in hospital course of children hospitalized with community-acquired pneumonia with or without radiologically-confirmed pneumonia: a retrospective cohort study |
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Differences upon admission and in hospital course of children hospitalized with community-acquired pneumonia with or without radiologically-confirmed pneumonia: a retrospective cohort study |
abstract |
Background The use of chest radiograph (CXR) for the diagnosis of childhood community-acquired pneumonia (CAP) is controversial. We assessed if children with CAP diagnosed on clinical grounds, with or without radiologically-confirmed pneumonia on admission, evolved differently. Methods Children aged ≥ 2 months, hospitalized with CAP diagnosed on clinical grounds, treated with 200,000 IU/Kg/day of aqueous penicillin G for ≥ 48 h and with CXR taken upon admission, without pleural effusion, were included in this retrospective cohort. One researcher, blinded to the radiological diagnosis, collected data on demographics, clinical history and physical examination on admission, daily hospital course during the first 2 days of treatment, and outcome, all from medical charts. Radiological confirmation of pneumonia was based on presence of pulmonary infiltrate detected by a paediatric radiologist who was also blinded to clinical data. Variables were initially compared by bivariate analysis. Multi-variable logistic regression analysis assessed independent association between radiologically-confirmed pneumonia and factors which significantly differed during hospital course in the bivariate analysis. The multi-variable analysis was performed in a model adjusted for age and for the same factor present upon admission. Results 109 (38.5 %) children had radiologically-confirmed pneumonia, 143 (50.5 %) had normal CXR and 31 (11.0 %) had atelectasis or peribronchial thickening. Children without radiologically-confirmed pneumonia were younger than those with radiologically-confirmed pneumonia (median [IQR]: 14 [7–28 months versus 21 [12–44] months; P = 0.001). None died. The subgroup with radiologically-confirmed pneumonia presented fever on D1 (33.7 vs. 19.1; P = 0.015) and on D2 (31.6 % vs. 16.2 %; P = 0.004) more frequently. The subgroup without radiologically-confirmed pneumonia had chest indrawing on D1 (22.4 % vs. 11.9 %; P = 0.027) more often detected. By multi-variable analysis, Fever on D2 (OR [95 % CI]: 2.16 [1.15-4.06]) was directly and independently associated with radiologically-confirmed pneumonia upon admission. Conclusion The compared subgroups evolved differently. © Simbalista et al. 2015 |
abstractGer |
Background The use of chest radiograph (CXR) for the diagnosis of childhood community-acquired pneumonia (CAP) is controversial. We assessed if children with CAP diagnosed on clinical grounds, with or without radiologically-confirmed pneumonia on admission, evolved differently. Methods Children aged ≥ 2 months, hospitalized with CAP diagnosed on clinical grounds, treated with 200,000 IU/Kg/day of aqueous penicillin G for ≥ 48 h and with CXR taken upon admission, without pleural effusion, were included in this retrospective cohort. One researcher, blinded to the radiological diagnosis, collected data on demographics, clinical history and physical examination on admission, daily hospital course during the first 2 days of treatment, and outcome, all from medical charts. Radiological confirmation of pneumonia was based on presence of pulmonary infiltrate detected by a paediatric radiologist who was also blinded to clinical data. Variables were initially compared by bivariate analysis. Multi-variable logistic regression analysis assessed independent association between radiologically-confirmed pneumonia and factors which significantly differed during hospital course in the bivariate analysis. The multi-variable analysis was performed in a model adjusted for age and for the same factor present upon admission. Results 109 (38.5 %) children had radiologically-confirmed pneumonia, 143 (50.5 %) had normal CXR and 31 (11.0 %) had atelectasis or peribronchial thickening. Children without radiologically-confirmed pneumonia were younger than those with radiologically-confirmed pneumonia (median [IQR]: 14 [7–28 months versus 21 [12–44] months; P = 0.001). None died. The subgroup with radiologically-confirmed pneumonia presented fever on D1 (33.7 vs. 19.1; P = 0.015) and on D2 (31.6 % vs. 16.2 %; P = 0.004) more frequently. The subgroup without radiologically-confirmed pneumonia had chest indrawing on D1 (22.4 % vs. 11.9 %; P = 0.027) more often detected. By multi-variable analysis, Fever on D2 (OR [95 % CI]: 2.16 [1.15-4.06]) was directly and independently associated with radiologically-confirmed pneumonia upon admission. Conclusion The compared subgroups evolved differently. © Simbalista et al. 2015 |
abstract_unstemmed |
Background The use of chest radiograph (CXR) for the diagnosis of childhood community-acquired pneumonia (CAP) is controversial. We assessed if children with CAP diagnosed on clinical grounds, with or without radiologically-confirmed pneumonia on admission, evolved differently. Methods Children aged ≥ 2 months, hospitalized with CAP diagnosed on clinical grounds, treated with 200,000 IU/Kg/day of aqueous penicillin G for ≥ 48 h and with CXR taken upon admission, without pleural effusion, were included in this retrospective cohort. One researcher, blinded to the radiological diagnosis, collected data on demographics, clinical history and physical examination on admission, daily hospital course during the first 2 days of treatment, and outcome, all from medical charts. Radiological confirmation of pneumonia was based on presence of pulmonary infiltrate detected by a paediatric radiologist who was also blinded to clinical data. Variables were initially compared by bivariate analysis. Multi-variable logistic regression analysis assessed independent association between radiologically-confirmed pneumonia and factors which significantly differed during hospital course in the bivariate analysis. The multi-variable analysis was performed in a model adjusted for age and for the same factor present upon admission. Results 109 (38.5 %) children had radiologically-confirmed pneumonia, 143 (50.5 %) had normal CXR and 31 (11.0 %) had atelectasis or peribronchial thickening. Children without radiologically-confirmed pneumonia were younger than those with radiologically-confirmed pneumonia (median [IQR]: 14 [7–28 months versus 21 [12–44] months; P = 0.001). None died. The subgroup with radiologically-confirmed pneumonia presented fever on D1 (33.7 vs. 19.1; P = 0.015) and on D2 (31.6 % vs. 16.2 %; P = 0.004) more frequently. The subgroup without radiologically-confirmed pneumonia had chest indrawing on D1 (22.4 % vs. 11.9 %; P = 0.027) more often detected. By multi-variable analysis, Fever on D2 (OR [95 % CI]: 2.16 [1.15-4.06]) was directly and independently associated with radiologically-confirmed pneumonia upon admission. Conclusion The compared subgroups evolved differently. © Simbalista et al. 2015 |
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Differences upon admission and in hospital course of children hospitalized with community-acquired pneumonia with or without radiologically-confirmed pneumonia: a retrospective cohort study |
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https://dx.doi.org/10.1186/s12887-015-0485-6 |
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Andrade, Dafne C. Borges, Igor C. Araújo, Marcelo Nascimento-Carvalho, Cristiana M. |
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We assessed if children with CAP diagnosed on clinical grounds, with or without radiologically-confirmed pneumonia on admission, evolved differently. Methods Children aged ≥ 2 months, hospitalized with CAP diagnosed on clinical grounds, treated with 200,000 IU/Kg/day of aqueous penicillin G for ≥ 48 h and with CXR taken upon admission, without pleural effusion, were included in this retrospective cohort. One researcher, blinded to the radiological diagnosis, collected data on demographics, clinical history and physical examination on admission, daily hospital course during the first 2 days of treatment, and outcome, all from medical charts. Radiological confirmation of pneumonia was based on presence of pulmonary infiltrate detected by a paediatric radiologist who was also blinded to clinical data. Variables were initially compared by bivariate analysis. Multi-variable logistic regression analysis assessed independent association between radiologically-confirmed pneumonia and factors which significantly differed during hospital course in the bivariate analysis. The multi-variable analysis was performed in a model adjusted for age and for the same factor present upon admission. Results 109 (38.5 %) children had radiologically-confirmed pneumonia, 143 (50.5 %) had normal CXR and 31 (11.0 %) had atelectasis or peribronchial thickening. Children without radiologically-confirmed pneumonia were younger than those with radiologically-confirmed pneumonia (median [IQR]: 14 [7–28 months versus 21 [12–44] months; P = 0.001). None died. The subgroup with radiologically-confirmed pneumonia presented fever on D1 (33.7 vs. 19.1; P = 0.015) and on D2 (31.6 % vs. 16.2 %; P = 0.004) more frequently. The subgroup without radiologically-confirmed pneumonia had chest indrawing on D1 (22.4 % vs. 11.9 %; P = 0.027) more often detected. 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