Associating a standardized reporting tool for chest radiographs with clinical complications in pediatric acute chest syndrome.

Autor: Morrone K; Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, USA., Andreca M; Department of Radiology, Yale New Haven Health, New Haven, Connecticut, USA., Silver EJ; Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, USA., Xiang A; Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, USA., Strumph K; Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, USA., Manwani D; Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, USA., Rinke ML; Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, USA., Kurian J; Department of Radiology, Westchester Medical Center, Valhalla, New York, USA., Orentlicher R; Department of Radiology, Mount Sinai Hospital, New York, New York, USA., Liszewski MC; Department of Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA.
Jazyk: angličtina
Zdroj: Pediatric pulmonology [Pediatr Pulmonol] 2023 Nov; Vol. 58 (11), pp. 3139-3146. Date of Electronic Publication: 2023 Sep 06.
DOI: 10.1002/ppul.26634
Abstrakt: Background: Acute chest syndrome (ACS) is an important cause of morbidity in sickle cell disease (SCD). A standardized tool for reporting chest radiographs in pediatric SCD patients did not previously exist.
Objective: To analyze the interobserver agreement among pediatric radiologists' interpretations for pediatric ACS chest radiographs utilizing a standardized reporting tool. We also explored the association of radiographic findings with ACS complications.
Methods: This was a retrospective cohort study of pediatric ACS admissions from a single institution in 2019. ICD-10 codes identified 127 ACS admissions. Two radiologists independently interpreted the chest radiographs utilizing a standardized reporting tool, a third radiologist adjudicated discrepancies, and κ analysis assessed interobserver agreement. Clinical outcomes were correlated with chest radiograph findings utilizing Pearsons' χ 2 , t tests, and Mann-Whitney U tests. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.
Results: Interobserver agreement was moderate to near-perfect across variables, with κ analysis showing near-perfect agreement for opacity reported in the right upper lobe (0.84), substantial agreement for right lower lobe (0.63), and vertebral bony changes (0.72), with moderate agreement for all other reported variables. On the initial chest radiograph, an opacity located in the left lower lobe (LLL) correlated with pediatric intensive care unit transfer (p = .03). Pleural effusion on the initial chest radiograph had a 3.98 OR (95% CI: 1.35-11.74) of requiring blood products and a 10.67 OR (95% CI: 3.62-31.39) for noninvasive ventilation.
Conclusion: The standardized reporting tool showed moderate to near-perfect agreement between radiologists. LLL opacity, and pleural effusion were associated with increased risk of ACS complications.
(© 2023 Wiley Periodicals LLC.)
Databáze: MEDLINE
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