Presentations of Infants to Emergency Departments in Alberta, Canada, for Bronchiolitis A Large Population-Based Study

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.