Introduction:

current national guidelines recommend routine chest x-rays to patients admitted with bronchiolitis. Recent publications suggest that performing chest x-rays to all admitted infants results in low performance rates in the diagnosis of complications and leads to higher rates of antibiotic prescription.

Objectives:

to analyze chest x-ray findings in admitted patients with bronchiolitis, and to evaluate whether x-rays findings determine modifications in medical treatment. Compare the interpretation of the x-rays between clinicians and radiologists.

Method:

observational study conducted in winter 2015, in the pediatric units of two different hospitals. X-rays were independently interpreted by clinicians and by one radiologist, following a single protocol.

Results:

82 patients were included in the study. According to the radiologist, 6 % showed complications or non-consistent findings with broncholitis in the chest x-ray (atypical). Clinicians and radiologists interpretation of chest x-rays were barely coincident. Clinicians diagnosed pneumonia more frequently than imagenologists (26% vs 6%), leading to higher antibiotic prescription. Clinicians diagnosed anitbiotics in x-rays informed as typical bronchiolitis by imagenologists.

Conclusions:

chest x-ray in admitted infants with bronchiolitis were either normal or typical in 93 % of normal or typical findings. Clinicians´ and radiologists´ interpretations differed significantly. Clinicians overdiagnosed pneumonia, and thus antibiotic prescription was higher based on their x-ray interpretation.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )