Background: Acute viral respiratory exacerbation is one of the most common conditions encountered in a\npaediatric emergency department (PED) during winter months. We aimed at defining clinical predictors of chest\nradiography prescription and radiographic abnormalities, among infants with bronchiolitis in a paediatric\nemergency department.\nMethods: We conducted a prospective cohort study of children less than 2 years of age with clinical bronchiolitis,\nwho presented for evaluation at the paediatric emergency department of an urban general hospital in France.\nDetailed information regarding historical features, examination findings, and management were collected. Clinical\npredictors of interest were explored in multivariate logistic regression models.\nResults: Among 410 chest radiographs blindly interpreted by two experts, 40 (9.7%) were considered as abnormal.\nClinical predictors of chest radiography achievement were age (under three months), feeding difficulties, fever over\n38�°C, hypoxia under than 95% of oxygen saturation, respiratory distress, crackles, and bronchitis rales. Clinical\npredictors of radiographic abnormalities were fever and close to significance hypoxia and conjunctivitis.\nConclusion: Our study provides arguments for reducing chest radiographs in infants with bronchiolitis. For infants\nwith clinical factors such as age less than three months, feeding difficulties, respiratory distress without hypoxia,\nisolated crackles or bronchitis rales, careful clinical follow-up should be provided instead of chest radiography
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