Duration of Illness in Infants With Bronchiolitis Evaluated in the Emergency Department

Abstract

OBJECTIVES: To describe the duration of illness in infants with first-time bronchiolitis who present to an emergency department (ED) and assess the burden of the illness on caregivers and families. METHODS: This was a prospective cohort study of infants younger than 12 months who presented to a tertiary care children's hospital ED with a first episode of bronchiolitis. Subjects were excluded if they had a history of bronchodilator use or immunocompromise. Demographic and clinical data were collected in the ED. Outcomes data were collected by weekly telephone interviews for 4 weeks or until the subject was free of cough for 24 hours. RESULTS: Ninety-five infants were enrolled from November 2007 to March 2008. Median duration of symptoms was 15 days; 25% of the infants remained symptomatic after 21 days. Subjects with a history of eczema trended toward a longer median duration of symptoms when compared with those who did not (18 days [interquartile range (IQR): 15.5–24] and 15 days [IQR: 11–19], respectively; P = .055). Duration of symptoms did not significantly vary with regards to respiratory syncytial virus status or secondhand smoke exposure. Subjects missed a median of 2.5 days (IQR: 0.5–5.5) of day care, and caregivers missed a median of 2 days (IQR: 1–4) of work. Of these infants, 37.1% (95% confidence interval: 24.3–44.1) had a subsequent unscheduled medical visit. CONCLUSIONS: Infants seen in the ED for bronchiolitis have a prolonged disease course, with substantial burden to the family. Symptom duration may be influenced by a propensity toward atopy. Clinicians may use this information for counseling families.