• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Emergency

Inpatient management of croup varies widely by hospital

byKate AndersonandLeah Carr, MD
March 14, 2017
in Emergency, Pediatrics
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Hospital-specific factors were found to be the main predictor of differences in use of not routinely indicated resources (NRIRs) for inpatient croup management.

2. The largest variation in use of NRIR among hospitals was seen in completion of viral studies and administration of parenteral steroids over preferred oral steroids.

Evidence rating level: 2 (Good)

Study Rundown: Croup is generally a mild, self-limited, clinically-diagnosed disease of viral-induced upper airway obstruction. Studies show that except in rare circumstances, use of ancillary testing is not warranted. While the majority of research surrounding croup is outpatient-based, up to 6% of the >1.4 million children diagnosed in the United States each year are admitted to the hospital. This retrospective cohort study attempted to address the paucity of data that exists regarding inpatient croup care. Researchers analyzed variation in NRIR use for inpatient management of croup in 26 hospitals across the United States, and attempted to identify patient and hospital-specific factors predicting NRIR utilization. Results showed patient characteristics including age, disease severity and days of hospitalization were associated with greater number of NRIR use. Overall, however, hospital-level rather than patient-related characteristics had a greater influence on variation in use of all NRIRs except antibiotics. The greatest variation in use among NRIRs included route of steroid administration for treatment and use of viral studies for diagnosis.

Of note, all hospitals included in this study were free-standing children’s hospitals, potentially representing a more severely ill patient population resulting in higher NRIR use. Alternatively, presence of more experienced providers or institutional care guidelines at these hospitals may have contributed to a lower NRIR use in this cohort. Further research specific to inpatient management of croup is needed to define best care practices in order to reduce unnecessary resource utilization while optimizing patient outcomes.

Click to read the study, published today in Pediatrics

Relevant reading: Viral croup: diagnosis and a treatment algorithm

RELATED REPORTS

Patient Basics: Croup

In-depth [retrospective cohort]: Study participants included 6236 generally healthy children aged 6 months to 14 years (median 18 months) admitted at 26 children’s hospitals with a primary or secondary diagnosis of croup. Those whose charts indicated that croup was likely secondary to another condition (e.g. surgical diagnoses, airway anomalies, etc.) were excluded from analysis.  Researchers collected data from the Pediatric Health Information System database, including patient level information (demographics, clinical presentation, treatment and outcomes) and hospital characteristics (croup admissions and annual patient census). NRIRs analyzed included parenteral steroids, viral studies, chests and lateral neck radiographs, and antibiotics. Results showed several variations in croup management based on hospital. For example, depending on the hospital, parenteral steroid use ranged from 16-88%, use of viral studies ranged from 1-40% and use of ≥ 2 NRIRs ranged from 16-60% at the hospital level. Patient characteristics including age ≥ 3years, black race, discharge in a season other than fall, and disease severity were associated with higher odds of receiving ≥2 NRIRs.  Apart from antibiotic use, risk-adjusted analysis showed wide differences in use of NRIR across hospitals, demonstrating hospital-specific effects were the main predictor of variability. Conversely, hospital-level variation in patient outcomes were not as pronounced. Based on hospital, rates of intubation ranged from 0-6%, proportion of 30 day readmission ranged from 0-3% and rates of return to ED within one week were between 0-3%. Data failed to show a clear association between NRIR use and patient outcomes.

Image: CC/Wiki/Dr. Frank Gaillard

©2017 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: Croup
Previous Post

Suboptimal dietary habits linked to deaths from heart disease, stroke, and type 2 diabetes

Next Post

Association between maternal body mass index in early pregnancy and incidence of cerebral palsy

RelatedReports

Health A to Z

Patient Basics: Croup

November 30, 2014
Next Post
Ear infections decreasing in infants

Association between maternal body mass index in early pregnancy and incidence of cerebral palsy

MMF and rituximab combination effective in nephrotic syndrome

Evolocumab demonstrated to have long-term efficacy at lowering low-density lipoprotiein: The Osler-1 trial

Survivors of adult-onset cancers associated with increased incidence of cardiovascular disease

Pembrolizumab improves median survival amongst those with recurrent urothelial carcinoma

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Aspirin thromboprophylaxis noninferior to low-molecular-weight heparin in patients with fractures
  • Catheter ablation reduces rates of persistent atrial fibrillation and atrial tachyarrhythmia
  • Deep intronic FGF14 repeat expansion associated with late-onset cerebella ataxia
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options