Duration of illness in ambulatory children diagnosed with bronchiolitis

Objectives: To measure the duration of illness in ambulatory children diagn osed with bronchiolitis and to examine clinical predictors of duration of i llness. Design: Validation inception cohort study. Duration of follow up was 28 day s. Setting: A primary-level ambulatory department of a public sector children' s hospital in Cape Town, South Africa. Patients: One hundred eighty-one children aged 2 to 23 months who went to t he hospital as their first contact for that episode of illness, and had a c linical diagnosis of bronchiolitis were enrolled consecutively on weekday m ornings if their guardian stated that they were contactable by telephone. Main Outcome Measure: Resolution of symptoms, as judged by the guardian, me asured by twice-weekly telephone interviews. Results: Median duration of illness (calculated as the reported duration of symptoms before initial hospital visit plus the time from first consultati on to recovery) was 12 days (95% confidence interval, 11-14 days). After 21 days, 18% were still ill and after 28 days, 9% were still ill. Sixty-two p atients (34.2%) had unscheduled consultations within 28 days, a median of 1 3 days after the first consultation. There was no association of duration o f illness with age, sex, 2 score for weight for age, or respiratory rate. Conclusions: Ambulatory children diagnosed with bronchiolitis recover with few complications, but the resolution of symptoms may take several weeks. P roviding parents with this information could help reduce the high rate of u nscheduled return visits as observed in this cohort.