Patient selection: child with respiratory symptoms
Parameters for clinical score:
(1) wheezing and/or stridor
(2) decreased breath sounds on one side
(3) cyanosis and/or respiratory insufficiency
Parameters for radiological score:
(1) hyperinflation on one side
(2) shift in mediastinum
(3) foreign body in chest CT
(4) opaque foreign body on chest X-ray
|
Parameter
|
Finding
|
Points
|
|
wheezing and/or stridor
|
absent
|
0
|
|
|
present
|
1
|
|
decreased breath sounds
|
on one side
|
2
|
|
|
other
|
0
|
|
cyanosis or respiratory insufficiency
|
absent
|
0
|
|
|
present
|
2
|
|
hyperinflation
|
on one side
|
1
|
|
|
other
|
0
|
|
shift in mediastinum
|
absent
|
0
|
|
|
present
|
2
|
|
foreign body CT
|
absent
|
0
|
|
|
present
|
3
|
|
opaque foreign body chest X-ray
|
absent
|
0
|
|
|
present
|
3
|
subscore for clinical findings =
= SUM(points for all 3 parameters)
subscore for radiological score =
= SUM(points for all 4 parameters)
total score =
= SUM(two subscores)
Interpretation:
• minimum total score: 0
• maximum total score:14
• The higher the score the greater the likelihood of a foreign body aspiration (especially if one is visualized)
• A score > 2 has the highest Youden index (sensitivity 77.9% and specificity 74.8%).
