Predicting the clinical course of suspected acute viral upper respiratory tract infection in children.
BACKGROUND
Suspected acute viral upper respiratory tract infection (SAVURTI) is the commonest acute reason why children consult in general practice. The clinical course varies widely and about one in five children re-consult for the same SAVURTI episode. If clinicians had feasible tools for predicting which children are likely to suffer a prolonged course, then additional explanations and possibly treatments could be provided at the initial consultation that might enable carers to manage the condition without re-consulting.


OBJECTIVE
To identify features available on the day of consulting that might predict a prolonged clinical course among children with SAVURTI.


METHODS
Regression analysis using Canadian Respiratory Illness and Flu Scale (CARIFS) data from a randomized controlled trial cohort of children aged from 6 months to 12 years consulting in general practice with SAVURTI.


RESULTS
Two variables from the clinician's records ('age' and 'cough') and two variables from the CARIFS completed by carers on the day of consulting ('fever' and 'low energy, tired') explained approximately 15% of the variation present in CARIFS scores on day seven.


CONCLUSIONS
Children and carers may benefit from a clear account of the evidence that the clinical course of RTIs in children varies widely and may be longer that expected, and that prediction for individuals is difficult.
Butler
Christopher C
CC
Department of General Practice, Cardiff University, Llanedeyrn Health Centre, Cardiff CF23 9PN, UK. butlercc@cf.ac.uk
Hood
Kerenza
K
Kinnersley
Paul
P
Robling
Mike
M
Prout
Hayley
H
Houston
Helen
H
D000208:Acute Disease; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002170:Canada; D002648:Child; D002675:Child, Preschool; D004205:Cromolyn Sodium / Q000627:therapeutic use; D005194:Family Practice; D006801:Humans; D007223:Infant; D008499:Medical Records; D010817:Physician-Patient Relations; D011237:Predictive Value of Tests; D012017:Referral and Consultation; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology
D018927:Anti-Asthmatic Agents; D000900:Anti-Bacterial Agents; D004205:Cromolyn Sodium