Clinical and therapeutic variables influencing hospitalisation for bronchiolitis in a community-based paediatric group practice.
OBJECTIVE
To examine the effect of different clinical characteristics and different treatments on the hospitalisation of infants with bronchiolitis seen in an outpatient clinic setting.


METHODS
The medical records of infants under 2 years of age who presented with a first episode of wheezing over a two-year period were reviewed retrospectively. Hospitalisation within ten days of evaluation was used as the primary outcome measure.


RESULTS
Data from 320 patients were included. 17% were hospitalised. Age was lower in the hospitalised patients (4.9 months vs. 7.1, p<0.001). Hospitalisation was higher in RSV-positive versus RSV-negative patients (38% vs. 10%, p<0.001) and was higher in those children who had been exposed to tobacco smoke versus those who hadn't (24% vs. 12%, p<0.01). Treatment with oral corticosteroids was associated with fewer hospitalisations in those patients with a family history of asthma or allergic rhinitis (9.7% vs. 24%, p=0.02) and in RSV-negative patients (2.5% vs. 16.7%, p<0.05).


CONCLUSIONS
Early treatment of bronchiolitis with oral corticosteroid in an outpatient clinic setting was associated with lower hospitalisation rates in patients with a family history of asthma or allergic rhinitis and in RSV-negative patients.
Al-Shawwa
Baha
B
Instructor of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. balshaww@mcw.edu
Al-Huniti
Nidal
N
Weinberger
Miles
M
Abu-Hasan
Mutasim
M
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000322:Adrenergic Agonists / Q000627:therapeutic use; D000420:Albuterol / Q000627:therapeutic use; D001988:Bronchiolitis / Q000188:drug therapy*; D004781:Environmental Exposure; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D014028:Tobacco Smoke Pollution
D000305:Adrenal Cortex Hormones; D000322:Adrenergic Agonists; D014028:Tobacco Smoke Pollution; D000420:Albuterol