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Management of Bronchiolitis in Community Hospitals in Ontario: a Multicentre Cohort Study.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Plint, Amy C. Taljaard, Monica McGahern, Candice Scott, Shannon D. Grimshaw, Jeremy M. Klassen, Terry P. Johnson, David W. |
| Copyright Year | 2016 |
| Abstract | OBJECTIVES Bronchiolitis is the leading cause of hospital admission for infants, but few studies have examined management of this condition in community hospital settings. We reviewed the management of children with bronchiolitis presenting to community hospitals in Ontario. METHODS We retrospectively reviewed a consecutive cohort of infants less than 12 months old with bronchiolitis who presented to 28 Ontario community hospitals over a two-year period. Bronchiolitis was defined as first episode of wheezing associated with signs of an upper respiratory tract infection during respiratory syncytial virus season. RESULTS Of 543 eligible children, 161 (29.7%, 95% Confidence Interval (CI) 22.3 to 37.0%) were admitted to hospital. Hospital admission rates varied widely (Interquartile Range 0%-40.3%). Bronchodilator use was widespread in the emergency department (ED) (79.7% of patients, 95% CI 75.0 to 84.5%) and on the inpatient wards (94.4% of patients, 95% CI 90.2 to 98.6%). Salbutamol was the most commonly used bronchodilator. At ED discharge 44.7% (95% CI 37.5 to 51.9%) of patients were prescribed a bronchodilator medication. Approximately one-third of ED patients (30.8%, 95% CI 22.7 to 38.8%), 50.3% (95% CI 37.7 to 63.0%) of inpatients, and 23.5% (95% CI 14.4 to 32.7) of patients discharged from the ED were treated with corticosteroids. The most common investigation obtained was a chest x-ray (60.2% of all children; 95% CI 51.9 to 68.5%). CONCLUSIONS Infants with bronchiolitis receive medications and investigations for which there is little evidence of benefit. This suggests a need for knowledge translation strategies directed to community hospitals. |
| Starting Page | 443 |
| Ending Page | 452 |
| Page Count | 10 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S1481803516000075 |
| PubMed reference number | 26906352v1 |
| Volume Number | 18 |
| Issue Number | 6 |
| Journal | CJEM |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Accident and Emergency department Adrenal Cortex Hormones Albuterol Bronchiolitis Bronchodilator Agents Confidence Intervals Erectile dysfunction Hospital admission Hospitals, Community Laboratory Procedures Manuscripts Patients Pediatric emergency medicine Plain chest X-ray Plain x-ray Respiratory Sounds Respiratory Tract Diseases Respiratory Tract Infections Respiratory syncytial virus Ward (environment) inpatient |
| Content Type | Text |
| Resource Type | Article |
