An investigation into perihilar inflammatory change on the chest radiographs of children admitted with acute respiratory symptoms

Fergus Coakley, J. Green, A. C. Lamont, A. B. Rickett

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Abstract

Purpose: To determine the incidence, correlation with selected parameters and interobserver variability of radiographic perihilar inflammatory change (PIC) in previously well children under 3 years of age, who were hospitalized with acute respiratory symptoms. Patients and methods: A total of 113 previously well children under 3 years of age who were hospitalized with acute respiratory symptoms, and whose chest radiographs (CRGs) showed no focal pulmonary abnormality, were prospectively identified. The CRGs were read blindly by two radiologists. Each scored the degree of PIC on a five point scale as absent (0), borderline/ equivocal/indeterminate (1), mild but definite (2), moderate (3) and severe (4). Results: PIC was read as definitely present (mean PIC score greater than or equal to 2) in 65 (58%) patients. The mean PIC score correlated with overinflation (r = 0.45, P <0.01) and patient temperature (r = 0.22, P <0.05). The mean PIC score was significantly higher (2.1 vs 1.5, P <0.01) in those receiving antibiotics (n = 69). It was also significantly higher (2.4 vs 1.7, P <0.01) in those receiving supplemental oxygen (n = 26). PIC was not associated with duration of admission, presence of wheeze (n = 79), use of nebulized bronchodilators (n = 61) or RSV positivity (n = 32). The k value for interobserver variability indicated only fair agreement (k = 0.29) between the two readers on the five point scale and moderate agreement (k = 0.41) when the data was pooled into two groups (0 and 1 vs 2, 3 and 4). Conclusions: PIC is a common radiographic finding in children under 3 years of age who are hospitalized with acute respiratory symptoms. It is positively but weakly correlated with temperature, hyperinflation, antibiotic usage and supplemental oxygen administration. It is subject to substantial interobserver variability.

Original languageEnglish (US)
Pages (from-to)614-617
Number of pages4
JournalBrain and Language
Volume51
Issue number9
StatePublished - 1996
Externally publishedYes

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Observer Variation
Thorax
Oxygen
Anti-Bacterial Agents
Temperature
Bronchodilator Agents
incidence
Lung
present
Incidence
Radiographs
Values
Group

ASJC Scopus subject areas

  • Language and Linguistics
  • Neuroscience(all)
  • Experimental and Cognitive Psychology
  • Neuropsychology and Physiological Psychology

Cite this

An investigation into perihilar inflammatory change on the chest radiographs of children admitted with acute respiratory symptoms. / Coakley, Fergus; Green, J.; Lamont, A. C.; Rickett, A. B.

In: Brain and Language, Vol. 51, No. 9, 1996, p. 614-617.

Research output: Contribution to journalArticle

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abstract = "Purpose: To determine the incidence, correlation with selected parameters and interobserver variability of radiographic perihilar inflammatory change (PIC) in previously well children under 3 years of age, who were hospitalized with acute respiratory symptoms. Patients and methods: A total of 113 previously well children under 3 years of age who were hospitalized with acute respiratory symptoms, and whose chest radiographs (CRGs) showed no focal pulmonary abnormality, were prospectively identified. The CRGs were read blindly by two radiologists. Each scored the degree of PIC on a five point scale as absent (0), borderline/ equivocal/indeterminate (1), mild but definite (2), moderate (3) and severe (4). Results: PIC was read as definitely present (mean PIC score greater than or equal to 2) in 65 (58{\%}) patients. The mean PIC score correlated with overinflation (r = 0.45, P <0.01) and patient temperature (r = 0.22, P <0.05). The mean PIC score was significantly higher (2.1 vs 1.5, P <0.01) in those receiving antibiotics (n = 69). It was also significantly higher (2.4 vs 1.7, P <0.01) in those receiving supplemental oxygen (n = 26). PIC was not associated with duration of admission, presence of wheeze (n = 79), use of nebulized bronchodilators (n = 61) or RSV positivity (n = 32). The k value for interobserver variability indicated only fair agreement (k = 0.29) between the two readers on the five point scale and moderate agreement (k = 0.41) when the data was pooled into two groups (0 and 1 vs 2, 3 and 4). Conclusions: PIC is a common radiographic finding in children under 3 years of age who are hospitalized with acute respiratory symptoms. It is positively but weakly correlated with temperature, hyperinflation, antibiotic usage and supplemental oxygen administration. It is subject to substantial interobserver variability.",
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