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Family Practice Advance Access published online on January 7, 2005
Family Practice, doi:10.1093/fampra/cmh713
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Family Practice © Oxford University Press 2004, all rights reserved.
Received July 16, 2004
Accepted September 27, 2004

Article

Predicting the clinical course of suspected acute viral upper respiratory tract infection in children

Christopher C. Butler 1*, Kerenza Hood 1, Paul Kinnersley 1, Mike Robling 1, Hayley Prout 1, and Helen Houston 1

1 Department of General Practice, Cardiff University, Llanedeyrn Health Centre, Cardiff CF23 9PN, UK

* To whom correspondence should be addressed.
Christopher C. Butler, E-mail: butlercc{at}cf.ac.uk


  Abstract

Background. Suspected acute viral upper respiratory tract infection (SAVURTI) is the commonest acute reason why children consult in general practice. The clinical course varies widely and about one in five children re-consult for the same SAVURTI episode. If clinicians had feasible tools for predicting which children are likely to suffer a prolonged course, then additional explanations and possibly treatments could be provided at the initial consultation that might enable carers to manage the condition without re-consulting.

Objective. To identify features available on the day of consulting that might predict a prolonged clinical course among children with SAVURTI.

Method. Regression analysis using Canadian Respiratory Illness and Flu Scale (CARIFS) data from a randomized controlled trial cohort of children aged from 6 months to 12 years consulting in general practice with SAVURTI.

Results. Two variables from the clinician's records (‘age’ and ‘cough’) and two variables from the CARIFS completed by carers on the day of consulting (‘fever’ and ‘low energy, tired’) explained approximately 15% of the variation present in CARIFS scores on day seven.

Conclusion. Children and carers may benefit from a clear account of the evidence that the clinical course of RTIs in children varies widely and may be longer that expected, and that prediction for individuals is difficult.

Keywords: Children; physician patient relationships; prognosis; upper respiratory tract infection; viral infection.
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