Burden and emergency department management of acute cough in children.
J Paediatr Child Health
; 55(2): 181-187, 2019 Feb.
Article
en En
| MEDLINE
| ID: mdl-30066972
ABSTRACT
AIM:
In children presenting to an emergency department (ED) with an acute coughing illness, the aims of this study were to (i) describe the frequency of doctor visits and medication use; and (ii) describe management and relate it to current evidence-based guidelines.METHODS:
This was a cross-sectional study in ED of a major teaching hospital (Royal Children's Hospital, Brisbane, Australia). Participants included 537 children (<15 years) presenting with acute (<2 weeks) cough, with a median age of 2.2 years (interquartile range 1.0-4.0); 61.5% were boys. Hospitalised children and those with asthma, pneumonia or chronic illnesses were excluded. Main outcome measures were (i) frequency of pre-ED doctor visits and medication use; and (ii) comparison of management to current evidence-based recommendations related to four discharge diagnoses bronchiolitis, 'wheeze/reactive airway disease (RAD)', croup and 'non-specific acute respiratory illness'.RESULTS:
A total of 300 children (55.9%) had seen a doctor prior to their ED presentation, and use of medications pre-ED was high (53.4%). While 93.4% of children with croup were treated in accordance with guidelines, concordance was lower for children with bronchiolitis or 'wheeze/RAD'. The majority of children with a discharge diagnosis of 'wheeze/RAD' (95.6%) received bronchodilators, and 72.7% also received oral corticosteroids but were not diagnosed with asthma. More than half (55.1%) of the children with non-specific acute respiratory illness received medication(s) either prior to or during their ED presentation.CONCLUSIONS:
The burden of acute cough-related illnesses in children is high, and there is a need for improved uptake of evidence-based guidelines. In addition, the large number of children diagnosed with 'wheeze/RAD' suggests asthma is likely under-diagnosed in this setting.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Costo de Enfermedad
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Tos
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Servicio de Urgencia en Hospital
Tipo de estudio:
Diagnostic_studies
/
Guideline
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Observational_studies
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Prevalence_studies
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Risk_factors_studies
Límite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Male
País/Región como asunto:
Oceania
Idioma:
En
Revista:
J Paediatr Child Health
Asunto de la revista:
PEDIATRIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Australia