Imperial College London
Alternate

DrSubarnaChakravorty

Faculty of Medicine, Department of Immunology and Inflammation

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 3299 3773s.chakravorty

 
 
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Location

 

Medical SchoolSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Griffin:2022:10.1111/bjh.17831,
author = {Griffin, R and Panayiotou, A and Allen, P and Height, S and Chakravorty, S and Rees, DC},
doi = {10.1111/bjh.17831},
journal = {Br J Haematol},
pages = {402--413},
title = {What is the role of chest X-ray imaging in the acute management of children with sickle cell disease?},
url = {http://dx.doi.org/10.1111/bjh.17831},
volume = {196},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Children with sickle cell disease (SCD) frequently present to hospital acutely unwell and are often exposed to diagnostic chest X-rays (CXRs). Little evidence exists to determine when CXRs are clinically useful. Using electronic hospital records, we audited CXR use in children aged 0-18 who presented to hospital over the past 10 years in both an inpatient and emergency department setting. From a total of 915 first CXRs, only 28·2% of CXRs (n = 258) had clinically significant findings that altered management or final diagnosis. Of these abnormalities, consolidation represented 52·3%, effusion 8·9%, cardiomegaly 8·4% and sickle cell-related bone changes 6·3%. Indications for CXR of respiratory distress (OR = 3·74, 95% CI 2·28-6·13), hypoxia (OR = 1·86, 95% CI 1·50-2·31) and cough (OR = 1·64, 95% CI 1·33-2·02), were more likely to have significant CXR findings. Patients who had higher peak fever (38·4°C vs. 37·4°C, P = 0·001), higher peak CRP (156·4 vs. 46·1, P < 0·001) and higher WCC (20·2 vs. 13·6, P < 0·001) were more likely to have clinically significant abnormalities on CXR. We found a decision tool using either hypoxia, cough, respiratory distress, T > 38°C, CRP > 50 or WCC > 15 × 109 /l as indications for CXR, to have a sensitivity of 88% (with 95% CI 0·78-0·95) and specificity of 46% (95% CI 0·43-0·50) for clinically significant findings.
AU  - Griffin,R
AU  - Panayiotou,A
AU  - Allen,P
AU  - Height,S
AU  - Chakravorty,S
AU  - Rees,DC
DO  - 10.1111/bjh.17831
EP  - 413
PY  - 2022///
SP  - 402
TI  - What is the role of chest X-ray imaging in the acute management of children with sickle cell disease?
T2  - Br J Haematol
UR  - http://dx.doi.org/10.1111/bjh.17831
UR  - https://www.ncbi.nlm.nih.gov/pubmed/34528246
VL  - 196
ER  -
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