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Post-consultation illness trajectories in children with acute cough and respiratory tract infection: prospective cohort study

Research output: Contribution to journalArticle

Original languageEnglish
Article numbercmy021
Number of pages8
JournalFamily Practice
Early online date20 Apr 2018
DOIs
DateAccepted/In press - 5 Mar 2018
DateE-pub ahead of print (current) - 20 Apr 2018

Abstract

Background

Little is known about respiratory tract infection (RTI) severity in children following consultation.

Objectives

To investigate post-consultation symptom trajectories in children with acute cough and RTI and whether baseline characteristics predict trajectory group.

Methods

Prospective cohort study of 2296 children (3 months–16 years) whose parents were invited to report cough severity and duration using a 7-point Likert scale. Longitudinal latent class analysis (LLCA) was used to identify post-consultation symptom trajectories in the first 15 days, and multinomial models to predict class membership.

Results

Complete data were available for 1408 children (61%). The best LLCA model identified five post-consultation symptom trajectory groups: ‘very rapid recovery’ (28.5%), ‘rapid recovery’ (37.7%), ‘intermediate recovery’ (18.2%), ‘persistent symptoms’ (9.5%) and ‘initial deterioration with persistent symptoms’ (6.0%). Compared with very rapid recovery, parent-reported severe cough in the 24 hours prior to consultation increased the likelihood of rapid recovery (OR 1.79 [95% CI 1.23, 2.60]), intermediate recovery (OR 2.13 [1.38, 3.30] and initial deterioration with persistent symptoms (OR 2.29 [1.26, 4.16]). Initial deterioration was also associated with ‘severe barking cough’ (OR 3.64 [1.50, 8.82]), ‘severely reduced energy in the 24 hours prior to consultation’ (OR 3.80 [1.62, 8.87] and higher parent-assessed illness severity at consultation (OR 2.21 [1.17, 4.18]).

Conclusion

We identified five distinct symptom trajectory groups showing the majority of children improved post-consultation, with only one group experiencing illness deterioration. The few characteristics associated with group membership did not fall into a pattern that seemed clinically useful.

Additional information

Crown copyright applies to the data in this study.

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    Rights statement: This is the final published version of the article (version of record). It first appeared online via Oxford University Press at https://academic.oup.com/fampra/advance-article/doi/10.1093/fampra/cmy021/4980524 . Please refer to any applicable terms of use of the publisher.

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    Licence: CC BY

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