Nearly half of children seen in ED for bronchiolitis get radiography

(HealthDay)—Despite guideline recommendations to the contrary, nearly half of children seen in the emergency department for bronchiolitis receive radiography, according to a research letter published online Oct. 16 in the Journal of the American Medical Association.

Brett Burstein, M.D.C.M., Ph.D., M.P.H., from Montreal Children's Hospital, and colleagues used emergency department data from the U.S. National Hospital Ambulatory Medical Care Survey (2007 to 2015) to estimate the annual frequency of radiography overall and in subgroups of admitted and discharged patients.

The researchers found that 612 children (median age, 8 months) had an emergency department diagnosis of bronchiolitis during the study period. The majority presented to nonteaching and nonpediatric hospitals. The researchers, who note that clinical practice guidelines from the American Academy of Pediatrics recommend against routine radiography in the evaluation of infants with bronchiolitis, found that 46.1 percent of the infants diagnosed with bronchiolitis received radiography. There was no change by year in the proportion of infants undergoing radiography. Overall radiography use was similar between patients discharged from the emergency department and admitted children. Higher rates of imaging were associated with nonpediatric hospitals and race identity other than black or white.

"These results suggest that nationwide quality initiatives are still needed to translate bronchiolitis guidelines into practice," the authors write.

One author disclosed ties to diagnostic and pharmaceutical companies.

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