Related Experiment Video
Updated: Jun 24, 2026
Evaluation of Host-Pathogen Responses and Vaccine Efficacy in Mice
Published on: February 22, 2019
When to discharge children hospitalized with pertussis?
Gideon Lurie1, Peter W Reed, Cameron C Grant
1General Pediatrics, Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand.
Insights
Clinical signs like paroxysmal cough and cyanosis can help determine safe discharge for children hospitalized with pertussis. These symptoms indicate a higher risk of readmission, guiding clinical decisions.
Area of Science:
- Pediatrics
- Infectious Diseases
- Respiratory Medicine
Background:
- Determining safe discharge for hospitalized pertussis patients is challenging.
- Identifying predictors of readmission is crucial for optimizing patient care and resource allocation.
Purpose of the Study:
- To identify clinical features associated with readmission in children hospitalized with pertussis.
- To inform clinical decision-making regarding discharge timing for pediatric pertussis patients.
Main Methods:
- A case series design was employed, analyzing data from 207 children hospitalized with pertussis.
- Readmitted children (n=33) were compared to non-readmitted children (n=174) to identify risk factors.
Main Results:
- No significant differences in demographics or immunization status were found between readmitted and non-readmitted groups.
- Children readmitted for pertussis experienced more cyanotic episodes per day and on a greater proportion of hospital days.
- Increased risk of readmission was associated with frequent cyanotic episodes and paroxysmal coughing on the last day of admission.
Conclusions:
- Paroxysmal cough and cyanosis are significant clinical indicators for predicting pertussis readmission in children.
- These clinical signs can aid healthcare providers in making informed decisions about when to safely discharge children from the hospital.
Objective:
It is difficult to know when children hospitalized with pertussis can be safely discharged. We sought to identify clinical features of children hospitalized with pertussis that are associated with readmission.
Methods:
A case series of 207 children hospitalized with pertussis was studied. The 33 children readmitted with pertussis were compared with the 174 who did not require readmission.
Results:
Demographic characteristics and immunization status of the children with pertussis requiring readmission did not differ from the children who were not readmitted. Median duration of initial hospital stay was 4 days for both groups (P=.11). The children who were readmitted had more cyanotic episodes per day (0.8 vs 0.0 episodes, P=.03) and on greater proportion of hospital days (0.5 vs 0.1, P=.01). On the last day of admission, the children subsequently readmitted had more coughing episodes (4 vs 0, P < .001), and a larger proportion had a cyanotic episode (30% vs 10%, P=.003). The risk of readmission was increased in children who had > or =1 cyanotic episode per day (relative risk [RR]=2.5, 95% confidence interval [95% CI] 1.3-4.6); cyanosis on > or =50% of days (RR=2.6, 95% CI 1.4-4.8);> or =2 coughing paroxysms on the last hospital day (RR=2.4, 95% CI 1.3-4.4); or any cyanosis on the last day (RR=2.9, 95% CI 1.5-5.2).
Conclusions:
Paroxysmal cough and cyanosis are clinical signs that can be used in children hospitalized with pertussis to help decide when to discharge them from hospital.
Related Concept Videos
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the progression...
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
01:17Transmission-based Precautions I: Contact, Enteric, and Droplets
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...