A Single-Institution Experience in the Use of Chest Radiographs for
Hospitalized Children Labelled as Asthma Exacerbation
Background: Risks of cancer have become more notable lately, especially
for young children with a chronic condition such as atopy. This study
reports on cumulative radiation from chest radiographs in children with
asthma. Its main aims were to consider our current practice, and suggest
minimizing chest radiograph use in this vulnerable people. Methods: The
study was retrospective and conducted at tertiary center. Eligibility
criteria included children 2-15 y who were admitted between January-2017
and December-2018 for asthma management. Results: Of 643 children who
were admitted as ‘asthma exacerbation’, 243 (40% females; age
[mean±SD] 5.4±3.3 y) met the study criteria for inclusion.
Ninety-two (38%) children had temperature 38.8±0.7oC on the day of
admission. Antibiotics were prescribed for 148 (61%) children, mainly
for presumed pneumonia. Chest radiographs were requested for 214 (88%)
children, mainly on the day of admission. Only 38 (18%) chest
radiographs showed focal/multifocal pneumonia justifying antibiotic use.
Significant predictors for requesting chest radiographs were antibiotic
use for presumed pneumonia, lower oxygen saturation at presentation, and
requesting blood culture. Rate of chest radiographs per year was
negatively related to child’s age; the younger the child the higher the
rate (model coefficient -0.259, P<0.001). For children
<5 y, rate of chest radiographs was 1.39±1.21/y and radiation
dose 0.028±0.025 mSV/y. The corresponding rates for children ≥5 y were
0.78±0.72/y and 0.008±0.007 mSV/y, respectively (P<0.001).
Conclusion: Chest radiographs were commonly requested for children with
asthma, especially the young ones. Prospective studies are necessary to
measure the impact of this practice on their health.