Identifying children with pneumonia in the emergency department

E. Melinda Mahabee-Gittens, Jacqueline Grupp-Phelan, Alan S. Brody, Lane F. Donnelly, Sheryl E.Allen Bracey, Elena M. Duma, Mia L. Mallory, Gail B. Slap

Research output: Contribution to journalArticle

54 Scopus citations


Emergency physicians need to clinically differentiate children with and without radiographic evidence of pneumonia. In this prospective cohort study of 510 patients 2 to 59 months of age presenting with symptoms of lower respiratory tract infection, 100% were evaluated with chest radiography and 44 (8.6%) had pneumonia on chest radiography. With use of multivariate analysis, the adjusted odds ratio (AOR) and 95% confidence intervals (CI) of the clinical findings significantly associated with focal infiltrates were age older than 12 months (AOR 1.4, CI 1.1-1.9), RR 50 or greater (AOR 3.5, CI 1.6-7.5), oxygen saturation 96% or less (AOR 4.6, CI 2.3-9.2), and nasal flaring (AOR 2.2 CI 1.2-4.0) in patients 12 months of age or younger. The combination of age older than 12 months, RR 50 or greater, oxygen saturation 96% or less, and in children under age 12 months, nasal flaring, can be used in determining which young children with lower respiratory tract infection symptoms have radiographic pneumonia.

Original languageEnglish (US)
Pages (from-to)427-435
Number of pages9
JournalClinical Pediatrics
Issue number5
StatePublished - Jun 1 2005
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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