The diagnostic performance and utility of chest XR in relation to chest CT in nontraumatic respiratory emergency patients
Nigerian Journal of Clinical Practice, cilt.26, sa.4, ss.438-446, 2023 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 26 Sayı: 4
- Basım Tarihi: 2023
- Doi Numarası: 10.4103/njcp.njcp_458_22
- Dergi Adı: Nigerian Journal of Clinical Practice
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, MEDLINE
- Sayfa Sayıları: ss.438-446
- Anahtar Kelimeler: Computed tomography, consistency, emergency medicine, nontraumatic, radiography, respiratory pathology
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background and Aim: This study aimed to determine the diagnostic performance and utility of chest radiography in relation to chest computed tomography (CT) in nontraumatic respiratory emergency patients. Patients and Methods: Patients presenting to the emergency department with respiratory complaints due to nontraumatic pathologies and who had consecutive chest XR and chest CT assessments with an interval of fewer than 6 hours were enrolled in the study (n = 561). Results: The two methods were determined to be consistent with moderate agreement in detecting pleural effusion (κ = 0.576, P < 0.001), pneumothorax (κ = 0.567, P < 0.001), increased cardiothoracic ratio (κ =0.472, P < 0.001), and pneumonic consolidation (κ = 0.465, P < 0.001). The consistency rate was significantly higher in patients aged <40 years (95.5% in ≤30 years and 90.9% in 31-40 years) as compared to older patients (81.8%, 68.2%, and 72.7% in 41-60 years, 61-80 years, and >80 years, respectively; P < 0.001 for each). The consistency rate was also higher for posteroanterior (PA) chest XR views than for anteroposterior (AP) chest XR views (72.7% vs. 68.2%, P = 0.005) and for high- and moderate-quality chest XR views than for poor-quality views (72.7% and 77.3% vs. 70.5%, P = 0.001). Conclusion: The consistency between the chest XR and CT was more likely in patients aged <40 years and for PA and moderate-to-high quality chest XR views, as compared to older patients and AP and poor-quality views, respectively. We suggest that an upright position PA chest X-ray with high imaging quality may be the first choice, especially in patients aged <40 years admitted to the emergency department with respiratory symptoms.