Reliable quantitative score for grading chest X-ray using the dynamic of blood cell count in adult asthma

Abstract

The purpose of the present study was to rate the level of spread of asthma-induced bronchial morphological changes on chest X-ray (CXR), using the modified Shwachman-Kulczycki (S-K) rating scale as predicted by the dynamic of blood cell count (CBC). A sample of 40 asthma patients' records was classified into 4 groups based on their clinical presentations and frequency of their visits to the hospital; Group-1 62 visits per week with reversible symptoms, Group-2 P2 visits per week with irreversible symptoms, Group-3: P3-4 visits per week with irreversible symptoms; Group-4: patients with severe shortness of breath in whom SaO 2 was threatening, hence were admitted as inpatients. Patients' CXR were scored based on the modified Shwachman-Kulczycki (S-K) scale rating. Blood analysis showed that RBC and their indices (HCT, HGB, MCH, RDW) were highest in group-2. White blood cells and their derivatives (NEU, EOS and LYM) were highest in group 4. CXR for group-2 showed bilateral increased bronchovascular markings but normal both lung fields and ruled out for costo-phrenic angles type of fever. Chest X-ray for group-3 showed hyperinflation, perihilar marking associated with bronchial thickening and unfolding aorta. In patients in group-4 development of broncho-pneumonic infiltration type of SOB and some evidence of bronchial edema with significant (p < 0.05) elevation in WBC were observed. The regression of S-K score on the dynamic of some CBC parameters was significant (p < 0.05). The best subsets that describe the model were:S-K ¼ 14:242 þ b1 NEUðÀ1:28Þ þ b2 EOSðÀ10:929Þ þ b3 HCTð0:577Þ þ b4 HGBðÀ:898Þ þ b5 RDWð0:546Þ þ b6 RBCðÀ1:966Þ þ e