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Pneumonia in children: new models can reduce x-rays

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To streamline the process of diagnosing community-acquired pneumonia and reduce the need for x-rays, a team of US researchers have devised a model that predicts patients with high or low risk of community-acquired pneumonia.

In young children, pneumonia, an infection that causes the lungs to fill with water, can be life-threatening in severe cases, and it is important to identify when the child has developed in the community.

While the standard procedure is to use x-rays to confirm the diagnosis, there are recommendations to limit the use of x-rays that researchers have hoped to address.

“The community-acquired predictive model of pneumonia is an important step in safely reducing radiation exposure in children,” said an emergency physician at Lully Children’s Hospital in Chicago and an assistant professor of pediatrics at Northwestern University School of Medicine. ,research, Said in a press release. “Patients with a low risk of pneumonia can also avoid unnecessary antibiotic use.”

To create a model that can predict which children are at increased risk of pneumonia, the study examined the records of 1,142 patients aged 3 months to 18 years who had previously been tested for community-acquired pneumonia.

By examining these records, researchers narrowed down some common features that could help indicate whether the risk of pneumonia is high or low. These include increasing age, duration of fever, and breathing with reduced sound during stethoscope examination.

Of the 1,142 patients, 253 were confirmed by X-ray to have community-acquired pneumonia. These patients tend to be older, with prolonged fever and “reduced local breath sounds.”

A runny nose and wheezing were negatively associated with pneumonia in this study, even though they are symptoms that may indicate illness.

“Our model does not rely on lab results, which may allow for broader implementation in primary care environments,” said Ruri Children’s Hospital, Director of Emergency Medicine Research, Northwestern University. Said in a release of a study by Dr. Todd Florin, an associate professor of pediatrics and a senior author.

“If validated by other centers, this model can be implemented using an online risk calculator or through a clinical decision support tool that can be embedded in electronic medical records.”

All patients in this study had a lower respiratory tract infection that was sourced from the same center, Ann & Robert H. Lurie Children’s Hospital in Chicago, and prompted them to have a chest x-ray for pneumonia.

This model is not intended to replace X-rays as a diagnostic tool for community-acquired pneumonia, but it may help reduce exposure of children to X-rays if the risk of pneumonia is very low. ..

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