Role of Chest X-ray in Predicting Outcome of Acute Severe Pneumonia

Objective: Radiological appraisal in children with clinically diagnosed severe pneumonia and its association with clinical outcome. Design: Prospective. Setting: Civil Hospital in Himachal Pradesh. Patients: Eighty-three children hospitalized with severe pneumonia. Results: Lobar consolidation (n=43, 51.8%) was the most common radiological abnormality. Twenty six (31.3%) had interstitial abnormalities and 14(16.9%) had normal chest radiographs. Clinical characteristics at admission could not predict a radiographic abnormality. Time to defervescence for outcome measures of fever and tachypnea was similar in children with consolidation, interstitial pneumonia or normal radiograph. However, length of hospital stay was significantly longer in children with abnormal chest radiographs on univariate analysis. Conclusion: Radiological findings in hospitalized children with clinically defined severe pneumonia have limited value in predicting clinical improvement.