Bronchiolitis Severity Based on Modified Tal Score and Chest X-ray Findings; Is There any Association?

Background: This study was performed to determine the relationship between chest X-ray findings and the severity of bronchiolitis using the modified Tal score scale (MTS). Methods: This retrospective study was conducted among ۹۹۹ children aged ۲-۲۴ months admitted to a referral teaching hospital in Isfahan, Iran. The severity of bronchiolitis was determined by MTS criteria, with scores ranging from ۰ to ۱۲. We considered scores ۰-۵ mild, ۶-۹ moderate, and ۱۰-۱۲ severe bronchiolitis. The patient's CXRs were also extracted from the hospital's picture archiving and communication system (PACS) and reported by an expert Pediatric radiologist. The radiologic findings were compared with the MTS criteria.Results: The mean (SD) of the MTS score in the patients was ۴.۵۸ ± ۱.۹۲. Overall, ۷۵۷ patients (۷۵.۷۸%) had normal radiographies. The frequency of normal radiography was ۷۵.۳% in the group of mild bronchiolitis and ۷۷.۳% in the group of moderate bronchiolitis. Reports of ۹ patients with severe disease showed that ۶ of them had normal CXRs (۶۶.۷%), ۲ had hyperinflation, and ۱ had atelectasis. There was no statistically significant relationship between radiographic results and the severity of bronchiolitis, according to MTS criteria (P = ۰.۲۳). The agreement between radiographic results and the severity of bronchiolitis was very weak (۰.۰۰۴) without statistical significance (P = ۰.۶۳۲). Conclusion: Considering that ۹۹.۳% of children with bronchiolitis do not have significant findings in chest X-rays, routine chest X-ray is not recommended in these patients.

Keywords:

Bronchiolitis , Early warning score , Mass chest X-ray