Methods: All children admitted to our inpatient Pediatric Unit with an episode of acute bronchiolitis from January 2011 to December 2012 were included. The following data were collected at admission: sex, age, neonatal history, past history of hospitalization for respiratory illnesses, heart rate, respiratory rate, presence of fever, fever duration prior to admission, oxygen saturation, laboratory parameters (ie, complete blood cell count, C-reactive protein [CRP], etc) and chest radiography. Nasopharyngeal samples were collected in order to detect respiratory viruses by polymerase chain reaction.
Results: The study comprised 355 infants (median age 8 months, boys 60.8%, positive respiratory syncytial virus 23.9%). Among them, 33 children had a chest radiograph revealing focal opacity (n=30, 30.8%), or atelectasis (n=3, 3.8%). Multivariate logistic regression analysis showed that, after adjusting for potentially confounding factors, the clinical predictors of abnormal chest radiography findings in children hospitalized with bronchiolitis were low oxygen saturation levels (<95%) (adjusted odds ratio [aOR], 0.085; 95% confidence interval [CI], 0.043-0.167; p<0.001) and elevated CRP levels (aOR, 1.211; 95% CI, 1.060-1.384; p=0.005).
Conclusions: Among children admitted with bronchiolitis, chest radiographs may be necessary for children with low oxygen saturation (<95%) or high CRP levels at admission.