RESEARCH ARTICLE


Imaging In Acute Bronchiolitis: Evaluation of The Current Practice In a Kuwaiti Governmental Hospital and Its Possible Impact on Hospitalization Period



Alaa Abdel-Kader1, 2, May Fouad Nassar1, 3, *, Zahra Qabazard1, Mohamed Disawi1
1 Pediatric Department, Al-Adan Hospital, MOH, Kuwait
2 Pediatric Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
3 Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt


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© 2018 Abdel-Kader et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Professor of Pediatrics, Faculty of Medicine, Ain shams University, Children`s Hospital, Ain Shams University, Abbassia, Cairo, Egypt, Tel: 00201068179772; E-mails: maynassar@med.asu.edu.eg; maie_nassar@yahoo.co.uk


Abstract

Background and objectives:

Guidelines for acute bronchiolitis recommend primarily supportive care, but unnecessary treatment measures remain well documented. This study was designed to assess the Al-Adan Hospital pediatricians` attitude towards imaging of inpatients with bronchiolitis aiming to evaluate its utilization and possible impact on patients` management and length of hospital stay.

Subjects and methods:

This study included 194 cases of acute bronchiolitis admitted to Al-Adan Hospital. Number of X-Rays done following admission and reasons stated in the files were recorded. Bronchiolitis severity was estimated from the data obtained.

Results:

Chest X-Rays were ordered in 52.1% of our inpatients with acute bronchiolitis. In nearly half of those cases, the reason for X-Ray request is a clinical severity factor, namely desaturations and apneas, and in rest of the cases, no specific reason for ordering X-Rays was documented. Significantly more patients who had two or more X-Rays were prescribed antibiotics and had statistically longer hospital stay. The number of X-Rays performed during admission was not a significant contributor to the need for PICU care, however, it was a significant factor affecting the length of hospital stay.

Conclusion:

The implementation of acute bronchiolitis guidelines regarding imaging in admitted cases with acute bronchiolitis is highly recommended in Al-Adan hospital. Clear documentation for the reasons behind ordering X-Rays is needed for those cases. A decrease in the X-Ray utilization and subsequent unnecessary antibiotic use can help in decreasing the costs and hazards of hospitalization for patients with acute bronchiolitis.

Keywords: Bronchiolitis, Imaging, Kuwait, Hospitalization, Period, X-ray, Pediatricians.