Acute asthma: chest x-rays were of little benefit in uncomplicated cases.

Clinical bottom line (level 4)

  1. In adults with uncomplicated acute asthma, chest x-rays yielded little information.
Findley and Sahn: Chest 1981; 80: 535-536
Expires November 2002

The study

Case series with ?objective ?blinded outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: emergency department, USA

60 patients (aged range 17 to 74 years; mean 39, 80% female) with 90 episodes of asthma

Excluded if
  • diagnosis of chronic bronchitis and emphysema

Outcomes studied:
  • normal
  • hyperinflation
  • chronic interstitial abnormalities
  • acute alveolar infiltrate

    • All patients had chest x-rays. Interpretation of the chest x-ray was performed by a staff radiologist and by the senior medical resident and attending physicians independently- if there was a disagreement, a third independent staff radiologist would interpret the x-ray.

    The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    normal ? 50/90 56%
    (45% to 66%)
    hyperinflation ? 33/90 37%
    (27% to 47%)
    chronic interstitial abnormalities ? 6/90 6.7%
    (1.5% to 12%)
    acute alveolar infiltrate ? 1/90 1.1%
    (0.0% to 3.3%)

    • No correlation between chest x-ray interpretation and hospitalisation was seen.

    Comments

    1. Chest x-rays are probably important in patients with severe asthma for excluding pneumothorax.

    Citation

    1. Findley LJ, and Sahn SA: The value of chest roentgenograms in acute asthma. Chest 1981; 80: 535-536
    Search Terms: acute asthma in Cochrane
    Contributor: Benny Wong, Chris Ball and Clare Wotton, June 2000
    Reviewer: Mitsuhiro Kamei

    Clinical Question.
    Patient asthma
    Intervention or Exposure prevalence
    Outcome normal/abnormal chest x-ray