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Presentations of infants to emergency departments in Alberta, Canada, for bronchiolitis: a large population-based
Rhonda J Rosychuk1, Terry P Klassen, Donald C Voaklander
1Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Insights
Bronchiolitis is a common cause of infant emergency department visits in Alberta. This study highlights trends in presentation rates, disparities, and a low rate of early follow-up, suggesting a need for targeted interventions.
Area of Science:
- Pediatrics
- Epidemiology
- Public Health
Background:
- Bronchiolitis is the leading cause of lower respiratory tract illness in infants.
- It accounts for a significant number of hospital admissions in Canada.
Purpose of the Study:
- To describe the epidemiology of bronchiolitis presentations to emergency departments (EDs) in Alberta, Canada.
- To analyze trends in ED visits, hospitalizations, and follow-up care for infants (aged ≤2 years).
Main Methods:
- Utilized provincial administrative databases for ED encounters from April 1999 to March 2005.
- Extracted data on infant demographics, visit timing, and subsequent healthcare utilization.
- Conducted data analysis using summaries and standardized rates.
Main Results:
- Analyzed 26,742 ED visits for bronchiolitis involving 18,155 infants.
- Observed an initial increase in standardized rates followed by a gradual decrease.
- Found that 22.6% of visits resulted in hospitalization, and 10.4% of discharged infants had a repeat ED visit within 7 days. A significant proportion (63.3%) lacked non-ED follow-up by 1 week.
Conclusions:
- Bronchiolitis is a frequent reason for pediatric emergency department visits in Alberta.
- Identified trends, age/sex/socioeconomic disparities, and a concerningly low rate of early follow-up.
- Recommended targeted interventions to decrease bronchiolitis-related hospitalizations.
Objectives:
Bronchiolitis is the most common lower respiratory tract disease among infants and results in 35 admissions per 1000 infants in Canada. We describe the epidemiology of bronchiolitis presentations to emergency departments (EDs) made by infants (aged ≤2 years) in Alberta, Canada.
Methods:
Provincial administrative databases were used to obtain all ED encounters for bronchiolitis during April 1999 to March 2005. Information included demographics, ED visit timing, and subsequent visits to non-ED settings. Data analysis included summaries and standardized rates.
Results:
There were 26,742 ED visits for bronchiolitis made by 18,155 infants. Most (74.9%) had only 1 bronchiolitis-related ED visit; males (60.6% of ED visits, 59.8% of infants) more commonly presented than females. The standardized rates increased from 23.2 to 46.7 per 1000 in 1999/2000 to 2000/2001 and decreased gradually to 38.8 per 1000 in 2004/2005. Of the total visits, 22.6% required hospitalization. In a discharged subset, 10.4% had a repeat ED visit within 7 days. Most infants (63.3%) had yet to have a non-ED follow-up visit by 1 week; median time to the first follow-up was 18 days.
Conclusions:
Bronchiolitis is a common presenting problem in Alberta EDs, and further study of these trends is required to understand variation in presentations. The important findings include different trends in rates for the first 3 years before a gradual decrease, disparities based on age, sex, and socioeconomic/cultural status, and the low rate of early follow-up. Targeted interventions could be implemented to reduce bronchiolitis-related hospitalizations.
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