TY - JOUR
T1 - The role of initial chest X-ray in triaging patients with suspected COVID-19 during the pandemic
AU - Kim, Hyunjoong W.
AU - Capaccione, K. M.
AU - Li, Gen
AU - Luk, Lyndon
AU - Widemon, Reginald S.
AU - Rahman, Ozair
AU - Beylergil, Volkan
AU - Mitchell, Ryan
AU - D’Souza, Belinda M.
AU - Leb, Jay S.
AU - Dumeer, Shifali
AU - Bentley-Hibbert, Stuart
AU - Liu, Michael
AU - Jambawalikar, Sachin
AU - Austin, John H.M.
AU - Salvatore, Mary
N1 - Funding Information:
Mary Salvatore, MD is a speaker and consultant for Genentech and Boehringer Ingelheim, and received grant funding from Genentech, Boehringer Ingelheim, and Lunglife AI.
Publisher Copyright:
© 2020, American Society of Emergency Radiology.
PY - 2020/12
Y1 - 2020/12
N2 - Purpose: The purpose of our research is to evaluate the usefulness of chest X-ray for triaging patients with suspected COVID-19 infection. Methods: IRB approval was obtained to allow a retrospective review of adult patients who presented to the Emergency Department with a complaint of fever, cough, dyspnea or hypoxia and had a chest X-ray between 12 March 2020 and 26 March 2020. The initial chest X-ray was graded on a scale of 0–3 with grade 0 representing no alveolar opacities, grade 1: < 1/3 alveolar opacities of the lung, Grade 2: 1/3 to 2/3 lung with alveolar opacities and grade 3: > 2/3 alveolar opacities of the lung. Past medical history of diabetes and hypertension, initial oxygen saturation, COVID-19 testing results, intubation, and outcome were also collected. Results: Four hundred ten patient chest X-rays were reviewed. Oxygen saturation and X-ray grade were both significantly associated with the length of stay in hospital, the hazard ratio (HR) of discharge was 1.05 (95% CI [1.01, 1.09], p = 0.017) and 0.61 (95% CI [0.51, 0.73], p < 0.001), respectively. In addition, oxygen saturation and X-ray grade were significant predictors of intubation (odds ratio (OR) of intubation is 0.88 (95% CI [0.81, 0.96], p = 0.004) and 3.69 (95% CI [2.25, 6.07], p < 0.001). Conclusions: Initial chest X-ray is a useful tool for triaging those subjects who might have poor outcomes with suspected COVID-19 infection and benefit most from hospitalization.
AB - Purpose: The purpose of our research is to evaluate the usefulness of chest X-ray for triaging patients with suspected COVID-19 infection. Methods: IRB approval was obtained to allow a retrospective review of adult patients who presented to the Emergency Department with a complaint of fever, cough, dyspnea or hypoxia and had a chest X-ray between 12 March 2020 and 26 March 2020. The initial chest X-ray was graded on a scale of 0–3 with grade 0 representing no alveolar opacities, grade 1: < 1/3 alveolar opacities of the lung, Grade 2: 1/3 to 2/3 lung with alveolar opacities and grade 3: > 2/3 alveolar opacities of the lung. Past medical history of diabetes and hypertension, initial oxygen saturation, COVID-19 testing results, intubation, and outcome were also collected. Results: Four hundred ten patient chest X-rays were reviewed. Oxygen saturation and X-ray grade were both significantly associated with the length of stay in hospital, the hazard ratio (HR) of discharge was 1.05 (95% CI [1.01, 1.09], p = 0.017) and 0.61 (95% CI [0.51, 0.73], p < 0.001), respectively. In addition, oxygen saturation and X-ray grade were significant predictors of intubation (odds ratio (OR) of intubation is 0.88 (95% CI [0.81, 0.96], p = 0.004) and 3.69 (95% CI [2.25, 6.07], p < 0.001). Conclusions: Initial chest X-ray is a useful tool for triaging those subjects who might have poor outcomes with suspected COVID-19 infection and benefit most from hospitalization.
KW - COVID-19
KW - CXR
KW - Chest
KW - Coronavirus
KW - SARS-CoV-2
KW - X-ray
UR - http://www.scopus.com/inward/record.url?scp=85086771868&partnerID=8YFLogxK
U2 - 10.1007/s10140-020-01808-y
DO - 10.1007/s10140-020-01808-y
M3 - Article
C2 - 32572707
AN - SCOPUS:85086771868
SN - 1070-3004
VL - 27
SP - 617
EP - 621
JO - Emergency Radiology
JF - Emergency Radiology
IS - 6
ER -