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Master Thesis

Pratiques de prescription de la radiographie pulmonaire chez les nourrissons consultant aux urgences pédiatriques du CHU de Bordeaux pour bronchiolite aigüe

Abstract : OBJECTIVE: Bronchiolitis is a common viral-induced lower tract infection, worldwidely affecting children under 2 years. Diagnostic is clinical, and no further testing is routinely required. However, chest x-rays (CXR) are still frequentely ordered in Pediatric Emergency Departments (PED), leading to higher costs, lengths of stay and use of antibiotics. The purpose of this study was to examine the habits of prescription of CXR in Bordeaux PED in children admitted for acute bronchiolitis. METHODS: Aretrospective study was performed, using the Hospital information System Database. All patient under 25 months of age admitted in the PED between the months of October 2014 and February 2015 for bronchiolitis were included. The realization of a CXR during initial stay in the PED and its interpretation by a pediatric radiologist were recorded. RESULTS: 803 admissions were recorded during those five months, with a total of 705 patients. 42% had a CXR during their initial stay in the PED. 48% were subsequentely admitted in the hospital. 27% of those CXR were considered pathological by a radiologist. In multivariate analysis, elevated respiratory rate, young age and fever were associated with higher prescription rates. The only variables related to abnormal CXR were young age and hypoxia. CONCLUSION: Prescription rate of initial CXR in our PED is elevated, with 72% of those realized to no avail. Omitting initial CXR in non critically ill patients has shown benefits in overall costs, efforts must be made to reduce our rate of prescription, reserving initial CXR to critically-ill patients with hypoxia, or strong suspicion of alternate diagnosis for better efficiency.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01381313
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Friday, October 14, 2016 - 12:36:19 PM
Last modification on : Wednesday, August 23, 2017 - 4:40:57 PM

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  • HAL Id : dumas-01381313, version 1

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Nora Traimond. Pratiques de prescription de la radiographie pulmonaire chez les nourrissons consultant aux urgences pédiatriques du CHU de Bordeaux pour bronchiolite aigüe . Médecine humaine et pathologie. 2016. ⟨dumas-01381313⟩

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