Clinical characteristics of patients with acute bronchiolitis who visited 146 Emergency Department in Korea in 2012

Eui Jung Roh; Youn Kyung Won; Mi-Hee Lee; Eun Hee Chung

doi:10.4168/aard.2015.3.5.334

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Roh, Won, Lee, and Chung: Clinical characteristics of patients with acute bronchiolitis who visited 146 Emergency Department in Korea in 2012

Original Article

Allergy, Asthma & Respiratory Disease 2015; 3(5): 334-340.

Published online: 30 September 2015

DOI: https://doi.org/10.4168/aard.2015.3.5.334

Clinical characteristics of patients with acute bronchiolitis who visited 146 Emergency Department in Korea in 2012

Eui Jung Roh¹, Youn Kyung Won², Mi-Hee Lee³, Eun Hee Chung²

¹Department of Pediatrics, Sun General Hospital, Daejeon, Korea.

²Department of Pediatrics, National Medical Center, Seoul, Korea.

³Department of Pediatrics, Seoul Women's Hospital, Incheon, Korea.

Correspondence to: Eun Hee Chung. Department of Pediatrics, National Medical Center, 245 Eulji-ro, Jung-gu, Seoul 04564, Korea. Tel: +82-2-2260-7301, Fax: +82-2-2276-2305, ehchung@nmc.or.kr

Received 28 April 2015 Revised 11 July 2015 Accepted 13 July 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

Abstract

Purpose

This study was aimed to investigate the clinical and epidemiological characteristics of the patients with acute bronchiolitis who visited in 146 Emergency Departments (EDs) in Korea in 2012.

Methods

We used the NEDIS (National Emergency Department Information System) database to obtain all children with acute bronchiolitis who visited ED under the age of 3 between January 1, 2012 and December 31, 2012.

Results

Totally 18,313 children with acute bronchiolitis were enrolled at this study. The male to female ratio was 1.55:1 and mean age was 10 months. The peak proportion was 17.3% in November during the whole year. The most common chief complaints were fever (38.5%), cough (37.4%), dyspnea (9.5%), gastrointestinal symptom (6.7%), and wheezing (2.5%). The most common accompanying disease was pneumonia (13.3%). The rate of hospital admission and intensive care unit admission were 34.5% and 0.3%, respectively. A predictor for admission via ED was respiratory difficulty.

Conclusion

These data expand our understanding of clinical characteristics of patients with acute bronchiolitis who visited all ED in Korea in 2012.

Keywords: Bronchiolitis, Emergency Department, Admission

Figures and Tables

Fig. 1

Number of children brought to an Emergency Department with acute bronchiolitis by age group in 2012.

Fig. 2

Monthly distribution of Emergency Department visits for bronchiolitis according to age group in 2012.

Fig. 3

Chief complains of acute bronchiolits in children at Emergency Department presentation in 2012. GI, gastrointestinal; Sx., symptom; URI, upper respiratory tract infection.

Fig. 4

Admission rate of the ward and ICU in children brought to an Emergency Department with acute bronchiolitis by age group in 2012. ICU, intensive care unit.

Fig. 5

Monthly trends in the percentage of ward and ICU admission rate of children brought to Emergency Department with acute bronchiolitis in 2012. ICU, intensive care unit.

Table 1

Combined disease of acute bronchiolitis who visited Emergency Department in 2012 (n=18,313)

Disease	No. of diseases (%)
Pneumonia	2,444 (13.3)
Gastroenteritis	1,118 (6.1)
Upper respiratory disease	1,049 (5.7)
Bronchial asthma	653 (3.6)
Croup	447 (2.4)
Acute otitis media	420 (2.2)
Acute pharyngotonsilitis	436 (2.4)
Acute bronchitis	400 (2.2)
Sepsis	163 (0.9)
Herpangina	118 (0.6)
Urinary tract infection	114 (0.6)
Hepatitis	95 (0.5)
Febrile convulsion	89 (0.5)
Sinusitis	52 (0.3)
Conjunctivitis	23 (0.1)
Urticaria	12 (<0.1)
Kawasaki disease	9 (<0.1)
Etc	57 (0.3)
Total	7,820 (42.7)

Table 2

Outcomes for children with acute bronchiolitis who visited Emergency Department in 2012

Variable	Age (mo)					Total
Variable	≤1	2-6	7-11	12-23	24-35	Total
Total	1,644 (9.0)	5,133 (28.0)	3,675 (20.1)	7,037 (38.4)	824 (4.5)	18,313 (100)
Hospitalization	687 (41.8)	1,976 (38.5)	1,264 (34.4)	2,194 (31.2)	200 (24.3)	6,321 (34.5)
Treat in ward	672 (40.9)	1,959 (38.2)	1,248 (34.1)	2,178 (31.0)	200 (24.2)	6,257 (34.2)
Treat in ICU	15 (0.9)^*	17 (0.3)^*	16 (0.4)^*	16 (0.2)^*	0 (0)^*	64 (0.3)^*
Discharge	946 (57.5)	3,122 (60.8)	2,391 (65.1)	4,810 (68.4)	624 (75.7)	11,893 (64.9)
Transfer	11 (0.7)	35 (0.7)	20 (0.5)	33 (0.5)	0 (0)	99 (0.5)

Values are presented as number (%).

ICU, intensive care unit.

^*Number (% per total admission).

Table 3

Clinical characteristics of intensive care unit admitted children with acute bronchiolitis who visited Emergency Department in 2012

Characteristic	Value
Total number, n (%)	64/18,313 (0.3)
Male:female	3.6:1
Mean age	7 mo 9 day
Chief complaint
Respiratory difficulty	40
Productive cough	14
Fever	5
Apnea	2
Lethargy	2
Febrile convulsion	1
Hospital duration (day), mean (range)	10.9 (4-49)
Monthly trends, n (%)
October	15 (23.4)
November	11 (17.1)
December	8 (12.5)
January	7 (10.9)
Combined disease
Pneumonia	13
Bronchial asthma	6
Sepsis	3
Gastroesophageal reflux	3
Gastroenteritis	2
Acute otitis media	1
Epilepsy	1
Urinary tract infection	1

Table 4

Univariate associations between patients features and hospital admission for acute bronchiolitis patients who visited Emergency Department in 2012

Variables	Admitted frequency, n (%)	P-value	Odds ratio (95% CI)
Total	6,321/18,313 (34.5)
Age (mo)		0.456
≤1	687/1,644 (41.8)		Reference
2-6	1,976/5,133 (38.5)		1.15 (0.25-1.31)
7-11	1.264/3,675 (34.4)		1.37 (0.33-1.94)
12-23	2,194/7,037 (31.2)		1.58 (0.45-2.15)
24-35	200/824 (24.2)		2.24 (0.99-2.57)
Sex		0.441
Male	3,946/11,121 (35.5)		Reference
Female	2,375/7,192 (33)		1.81 (0.75-2.17)
Chief complaints
Fever	2,348/7,046 (33.3)	0.231	0.92 (0.51-1.32)
Cough	2,607/6,850 (38.1)	0.115	1.28 (0.75-1.42)
Respiratory difficulty	1,088/1,739 (62.6)	0.001	4.91 (1.84-14.24)
Combined disease
Pneumonia	1,513/2,444 (61.9)	0.003	1.63 (1.10-3.21)
Asthma	410/793 (51.7)	0.004	1.47 (1.09-4.57)
Gastroenteritis	364/1,118 (32.6)	0.125	0.91 (0.75-2.22)
URI	131/1,049 (12.5)	0.508	0.26 (0.54-1.25)

CI, confidence interval; URI, upper respiratory infection.

Table 5

Multivariate associations between patients features and hospital admission for acute bronchiolitis patients who visited Emergency Department in 2012

	Admitted frequency (%)	P-value	Adjusted odds ratio (95% CI)
Respiratory difficulty	1,088/1,739 (62.6)	0.001	4.71 (1.52-13.24)

CI, confidence interval.

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ORCID iDs: Eun Hee Chung
https://orcid.org/http://orcid.org/0000-0001-9380-0151
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