Chest radiographs for acute lower respiratory tract infections (Review)

Cao, Amy Millicent Y., Choy, Joleen P., Mohanakrishnan, Lakshmi Narayana, Bain, Roger F. and van Driel, Mieke L. (2013) Chest radiographs for acute lower respiratory tract infections (Review). The Cochrane Database of Systematic Reviews, 12: CD009119.1-CD009119.34. doi:10.1002/14651858.CD009119.pub2


Author Cao, Amy Millicent Y.
Choy, Joleen P.
Mohanakrishnan, Lakshmi Narayana
Bain, Roger F.
van Driel, Mieke L.
Title Chest radiographs for acute lower respiratory tract infections (Review)
Journal name The Cochrane Database of Systematic Reviews   Check publisher's open access policy
ISSN 1469-493X
Publication date 2013
Year available 2013
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1002/14651858.CD009119.pub2
Issue 12
Start page CD009119.1
End page CD009119.34
Total pages 35
Place of publication Oxford, United Kingdom
Publisher John Wiley and Sons Ltd.
Collection year 2014
Language eng
Formatted abstract
Acute chest infections (lower respiratory tract infections) such as pneumonia, bronchitis and bronchiolitis are a major cause of deaths worldwide and expected to be amongst the leading four causes of death by 2030. The most affected population groups are children under 59 months and adults over 50 years of age. Patients with chest infections often have a fever, cough, shortness of breath and phlegm production. A chest X-ray is commonly used to help diagnose and manage chest infections and is widely used in high-income countries. However, the impact of chest X-rays in terms of how they may change patient recovery in suspected chest infection has not been evaluated. We focused on whether the use of chest X-rays compared to not using them led to improved outcomes such as a faster recovery rate, less time in hospital and fewer complications for the patient. We did not investigate the use of chest X-rays as a tool in the diagnosis of chest infections or the differences in the interpretation of X-rays between doctors.  Two trials with a total of 2024 participants were included in this review. The trial published in 1983 in the USA included only adults, while the trial in 1998 in South Africa included only children. Both trials were set in large metropolitan cities. We were unable to combine the results of the two studies due to incomplete data. However, both trials came to the same conclusion regarding the use of chest X-rays in chest infections, except in the subgroup of patients with evidence of infection (infiltrates) on their X-rays. In both adults and children, chest X-rays did not result in significant differences in recovery time. In summary, there were no differences in patient outcomes between the groups with or without chest X-ray. Although both studies suggest that chest X-rays do not improve patient outcomes, it is not clear if this finding can be applied to all populations and settings.   Results may be different in resource poor countries. Our conclusions are limited due to the lack of complete data available and by the risk of bias of the studies. Adverse effects of chest X-rays were not assessed by either study.We assessed the quality of the evidence from
both trials as being moderate. For the remainder of this review, X-rays will be referred to as radiographs.
Keyword Lower Respiratory tract infections
Morbidity
Mortality
Pneumonia
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Discipline of General Practice Publications
Official 2014 Collection
School of Medicine Publications
 
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Created: Wed, 22 Jan 2014, 12:36:46 EST by Shani Lamb on behalf of Discipline of General Practice