Association between hospitalised childhood pneumonia and follow-up chest radiographs in high-risk populations: a secondary analysis of a multicentre randomised controlled trial
Abstract
Objective As children hospitalised with community-acquired pneumonia (CAP) are at risk of persistent chest radiograph (CXR) abnormalities and respiratory sequelae, we investigated factors associated with incomplete CXR resolution at 4 weeks and 12 months post-discharge in children from populations at high-risk of chronic lung disease. Design Secondary analysis−multicentre, placebo-controlled, randomised controlled trial. Settings and patients 324 children aged 3 months to ≤5 years hospitalised with radiographic-confirmed CAP were enrolled from seven hospitals in Australia, New Zealand and Malaysia. After 1–3 days of intravenous antibiotics, then 3 days of oral amoxicillin–clavulanate, they were randomised to extended (13–14 days) or standard (5–6 days) courses of antibiotics. Intervention CXRs were performed at admission, 4 weeks, and 12 months post-discharge and reviewed in a blinded manner. Main outcome measures Radiographic changes of pneumonia at 4 weeks and 12 months post-discharge compared with admission CXRs. Results Among children with interpretable CXRs, incomplete resolution was seen in 42/253 (17%) at 4 weeks, and 29/212 (14%) at 12 months. Characteristics at admission associated with incomplete CXR resolution at 4 weeks were previous pneumonia hospitalisation (adjusted odds ratio [ORadj])=6.46, 95% confidence interval [CI] 2.21 to 18.85) and increasing age (ORadj=0.60 per-year, 95% CI 0.38 to 0.94). Continuing respiratory symptoms/signs at 4 weeks post-discharge…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 324 participants or records.
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