OBJECTIVES:To measure the duration of illness in ambulatory children diagnosed with bronchiolitis and to examine clinical predictors of duration of illness. DESIGN:Validation inception cohort study. Duration of follow up was 28 days. 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 the hospital as their first contact for that episode of illness, and had a clinical diagnosis of bronchiolitis were enrolled consecutively on weekday mornings if their guardian stated that they were contactable by telephone. MAIN OUTCOME MEASURE:Resolution of symptoms, as judged by the guardian, measured 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 consultation 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 patients (34.2%) had unscheduled consultations within 28 days, a median of 13 days after the first consultation. There was no association of duration of illness with age, sex, z 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. Providing parents with this information could help reduce the high rate of unscheduled return visits as observed in this cohort.

译文

目的:测量被诊断为毛细支气管炎的非卧床患儿的病程,并检查其病程的临床预测指标。
设计:验证起始队列研究。随访时间为28天。
地点:南非开普敦一家公共儿童医院的初级门诊部。
患者:一百一十八名年龄在2至23个月的儿童是该疾病的初次接触者,其病情经临床诊断为毛细支气管炎。如果监护人表示可以通过以下方式与他们联系,则他们在工作日的早晨连续入组:电话。
主要观察指标:监护人判断为症状缓解,方法是每周两次电话访谈。
结果:中位病程(以首次就诊前报道的症状持续时间加上从第一次咨询到康复的时间)为12天(95%置信区间为11-14天)。 21天后,仍有18%的病人生病,而28天后,仍有9%的病人生病。 62例患者(34.2%)在28天内进行了计划外的咨询,中位数为第一次咨询后的13天。疾病的持续时间与年龄,性别,年龄权重的z得分或呼吸频率没有关联。
结论:被诊断为毛细支气管炎的迁徙儿童可以恢复,并发症很少,但症状的缓解可能需要几周的时间。向父母提供此信息可以帮助减少在此队列中观察到的计划外回访的高比率。

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