Habilidad de la radiografía de tórax para predeciretiología en niños hospitalizados con neumonía

Abstract

Introduction: Distinguishing bacterial from viral pneumonia on admission to the hospital could guide thedecision of whether or not to use antibiotics. Objective: To evaluate the accuracy of chest radiograph topredict etiology (bacterial or viral) in 141 children aged under 10 years, hospitalized for pneumonia in whombacterial (n = 24) or viral (n = 117) etiology was identified. Methods: Chest radiograph evaluation was basedon Khamapirad score (-3 to 7 points), and blinded with regard to etiology. Results: Radiographic score washigher in bacterial pneumonias than in viral pneumonias (3.9 ± 0.92 vs -1.6 ± 1.3 points; p < 0.0001).Optimum cut-off value for the score was identified (ROC curve) at ≥ 2 points (sensitivity: 100%; specificity:94 %; positive predictive value: 77%; negative predictive value: 100%). Conclusion: The score tested isbased on easily identifiable elements in the chest radiograph. It accurately identifies children who do notneed antibiotics, it could be helpful in the management of community acquired pneumonia.