This article is more than 5 years old. Information may no longer be current.
Families, caregivers burdened by prolonged illness among infants with bronchiolitis
Petruzella FD. Pediatrics. 2010;doi:10.1542/peds.2009-2189.
Click Here to Manage Email Alerts
Symptoms of acute bronchiolitis persisted for nearly 3 weeks after the onset of illness in some infants seen in an ED, according to data from a prospective cohort study. As a result, caregivers and family members missed at least 1 day of work or school and some had to make arrangements for emergency alternate day care.
From November 2007 to March 2008, 95 infants younger than 12 months who presented with bronchiolitis at the Medical College of Wisconsin, Milwaukee, were enrolled. Patients who were immunocompromised or who had a history of bronchodilator use were excluded. Outcomes data were obtained via telephone interviews for 4 weeks or until the patient was cough-free for 24 hours.
Illness lasted a median of 15 days and 25% of patients were symptomatic at day 20; 11% of patients were symptomatic at the end of the 4-week follow-up. The researchers reported a trend toward longer duration of illness in infants with eczema and those with a family history of atopy compared with those without (median: 18 days vs. 15 days; P=.0547; median: 16 days vs. 14 days; P=.0627). However, respiratory syncytial virus, history of prematurity, exposure to tobacco smoke and disposition from the ED did not affect duration of illness.
As a secondary outcome, the researchers assessed the burden duration of illness placed on caregivers and families in the form of missed school or work and return medical visits. Of the 54% of caregivers who worked or attended school, 78% missed at least 1 day. Overall, caregivers missed a median of 2 days of school or work due to their child’s illness.
Fifty-nine infants saw a physician for re-evaluation after being discharged from the ED. Of these, 37% had at least one subsequent visit not recommended in the discharge instructions.
“Clinicians may use this information for counseling families in an attempt to reduce unscheduled return visits,” the researchers wrote. “Our data also suggest that symptom duration may be influenced by an infant’s propensity toward atopy. Future study is required to determine the true role of atopic tendency in the duration of illness in bronchiolitis.”