"X-rays can tell which swine flu patients need greater care"

Researchers at Tel Aviv Sourasky Medical Center in Israel, have found that X-rays can play an important role in the diagnosis and treatment of swine flu as it can predict which patients are likely to become sicker.

"Working in the emergency room is very stressful and physicians need information fast. Our study provides significant findings that will help clinicians triage patients presenting with clinically suspected H1N1 influenza," said lead author Galit Aviram.
In the study, published in Radiology journal, the team analysed the chest X-rays of 97 consecutive patients with flu-like symptoms and laboratory-confirmed diagnosis of H1N1, admitted to the emergency department of Tel Aviv Sourasky Medical Center between May and September 2009.

"To our knowledge, this is the largest series describing the presentation of chest X-ray findings in patients diagnosed with H1N1 influenza," Dr Aviram said.
The chest x-rays revealed abnormal findings for 39 of the patients, five (12.8 per cent) of whom experienced adverse outcomes, including death or the need for mechanical ventilation.

For the other 58 patients, chest X-ray findings were normal, although two (3.4 per cent) of the patients experienced adverse outcomes. The mean age of patients in the study, which included 53 men and 44 women, was 40.4 years.
"Abnormal findings in the periphery of both lungs and in multiple zones of the lungs were associated with poor clinical outcomes," Aviram said.

"Although a normal chest X-ray did not exclude the possibility of an adverse outcome," the author said, adding the study's findings can help physicians better identify high-risk H1N1 patients who require close monitoring".
The team said, "In H1N1, as in various types of community-acquired pneumonia, initial chest x-rays may not show abnormalities that develop later in the course of the disease and further X-rays should be performed according to the patient's clinical course".

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