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Butel T, Angoulvant F, Filipovic-Pierucci A, et al. Clinical course and cost assessment of infants with a first episode of acute bronchiolitis presenting to the emergency department: Data from the GUERANDE clinical trial. Pediatr Pulmonol. 2021;56(12):3802-3812doi: 10.1002/ppul.25621.
Butel, T., Angoulvant, F., Filipovic-Pierucci, A., Milcent, K., Teglas, J. P., Bellêttre, X., Claudet, I., Gras-le Guen, C., de Pontual, L., Minodier, P., Dubos, F., Brouard, J., Soussan-Banini, V., Degas-Bussiere, V., Gatin, A., Schweitzer, C., Epaud, R., Ryckewaert, A., Cros, P., Marot, Y., Flahaut, P., Saunier, P., Babe, P., Patteau, G., Delebarre, M., Titomanlio, L., Vrignaud, B., Trieu, T. V., Tahir, A., Regnard, D., Micheau, P., Charara, O., Henry, S., Ploin, D., Panjo, H., Vabret, A., Bouyer, J., Durand-Zaleski, I., & Gajdos, V. (2021). Clinical course and cost assessment of infants with a first episode of acute bronchiolitis presenting to the emergency department: Data from the GUERANDE clinical trial. Pediatric pulmonology, 56(12), 3802-3812. https://doi.org/10.1002/ppul.25621
Butel, Thibault, et al. "Clinical course and cost assessment of infants with a first episode of acute bronchiolitis presenting to the emergency department: Data from the GUERANDE clinical trial." Pediatric pulmonology vol. 56,12 (2021): 3802-3812. doi: https://doi.org/10.1002/ppul.25621
Butel T, Angoulvant F, Filipovic-Pierucci A, Milcent K, Teglas JP, Bellêttre X, Claudet I, Gras-le Guen C, de Pontual L, Minodier P, Dubos F, Brouard J, Soussan-Banini V, Degas-Bussiere V, Gatin A, Schweitzer C, Epaud R, Ryckewaert A, Cros P, Marot Y, Flahaut P, Saunier P, Babe P, Patteau G, Delebarre M, Titomanlio L, Vrignaud B, Trieu TV, Tahir A, Regnard D, Micheau P, Charara O, Henry S, Ploin D, Panjo H, Vabret A, Bouyer J, Durand-Zaleski I, Gajdos V. Clinical course and cost assessment of infants with a first episode of acute bronchiolitis presenting to the emergency department: Data from the GUERANDE clinical trial. Pediatr Pulmonol. 2021 Dec;56(12):3802-3812. doi: 10.1002/ppul.25621. Epub 2021 Sep 13. PMID: 34516722.
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Pediatr Pulmonol. 2021 Dec;56(12):3802-3812. doi: 10.1002/ppul.25621. Epub 2021 Sep 13.

Clinical course and cost assessment of infants with a first episode of acute bronchiolitis presenting to the emergency department: Data from the GUERANDE clinical trial.

Pediatric pulmonology

Thibault Butel, François Angoulvant, Antoine Filipovic-Pierucci, Karen Milcent, Jean-Paul Teglas, Xavier Bellêttre, Isabelle Claudet, Christèle Gras-le Guen, Loïc de Pontual, Philippe Minodier, François Dubos, Jacques Brouard, Valérie Soussan-Banini, Vanessa Degas-Bussiere, Amélie Gatin, Cyril Schweitzer, Ralph Epaud, Amélie Ryckewaert, Pierrick Cros, Yves Marot, Philippe Flahaut, Pascal Saunier, Philippe Babe, Géraldine Patteau, Mathilde Delebarre, Luigi Titomanlio, Bénédicte Vrignaud, Thanh-Van Trieu, Abdelilah Tahir, Delphine Regnard, Pascale Micheau, Oussama Charara, Simon Henry, Dominique Ploin, Henri Panjo, Astrid Vabret, Jean Bouyer, Isabelle Durand-Zaleski, Vincent Gajdos

Affiliations

  1. The Clinical Research Unit of Health Economics, APHP, Paris, France.
  2. Department of Pediatric Emergency, The Necker-Enfants Malades University Hospital, APHP, Paris, France.
  3. Department of Pediatric Emergency, Antoine Béclère University Hospital, APHP, Clamart, France.
  4. CESP Centre for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France.
  5. Department of Pediatric Emergency, Robert Debré University Hospital, APHP, Paris, France.
  6. Department of Pediatric Emergency, Toulouse University Hospital, Toulouse, France.
  7. Department of Pediatric Emergency, Nantes University Hospital, Nantes, France.
  8. Department of Pediatric Emergency, Jean Verdier University Hospital, APHP, Bondy, France.
  9. Department of Pediatric Emergency, Marseille Nord University Hospital, APHM, Marseille, France.
  10. Department of Pediatric Emergency, Lille University Hospital, Lille, France.
  11. Department of Pediatric Emergency, Caen University Hospital, Caen, France.
  12. Department of Pediatric Emergency, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt, France.
  13. Department of Pediatric Emergency, Sud-Francilien Hospital, Corbeil-Essonnes, France.
  14. Department of Pediatric Emergency, Nancy University Hospital, Nancy, France.
  15. Department of Pediatric Emergency, Creteil Intercommunal Hospital, Creteil, France.
  16. Department of Pediatric Emergency, Rennes University Hospital, Rennes, France.
  17. Department of Pediatric Emergency, Brest University Hospital, Brest, France.
  18. Department of Pediatric Emergency, Tours University Hospital, Tours, France.
  19. Department of Pediatric Emergency, Rouen University Hospital, Rouen, France.
  20. Department of Pediatric Emergency, Fontainebleau Hospital, Fontainebleau, France.
  21. Pediatric Emergency Department, Lenval University Hospital, Nice, France.
  22. Department of Pediatric Emergency, Limoges University Hospital, Limoges, France.
  23. Department of Pediatric Emergency, Bicêtre University Hospital, APHP, Kremlin-Bicêtre, France.
  24. Department of Pediatric Emergency, André Mignot Hospital, Le Chesnay, France.
  25. Department of Pediatric Emergency, Laennec Hospital, Quimper, France.
  26. Department of Pediatric Emergency, Mother Child University Hospital, HCL, Bron, France.

PMID: 34516722 DOI: 10.1002/ppul.25621

Abstract

INTRODUCTION: Bronchiolitis is the leading cause of hospitalization for infants but its economic burden is not well documented. Our objective was to describe the clinical evolution and to assess the 1-month cost of a first episode of acute bronchiolitis presenting to the emergency department (ED).

METHODS: Our study was an epidemiologic analysis and a cost study of the cohort drawn from the clinical trial GUERANDE, conducted in 24 French pediatric EDs. Infants of 6 weeks to 12 months of age presenting at pediatric EDs with a first episode of bronchiolitis were eligible. The costs considered were collected from a societal viewpoint, according to the recommendations of the French National Health Authority.

RESULTS: A total of 777 infants were included with a median age of 4 months. A total of 57% were hospitalized during the month following the first consultation in the ED, including 28 (3.6%) in an intensive care unit. The mean length of stay was 4.2 days (SD = 3.7). The average time to relief of all symptoms was 13 days (SD = 7). Average total cost per patient was €1919 (95% confidence interval: 1756-2138) from a societal perspective, mostly due to hospitalization cost. The estimated annual cost of bronchiolitis in infants was evaluated to be between €160 and €273 million in France.

DISCUSSION: Bronchiolitis represent a high cost for the health care system and broadly for society, with hospitalizations costs being the main cost driver. Thus significant investments should be made to develop innovative therapies, to reduce the number of hospitalizations and length of stay.

© 2021 Wiley Periodicals LLC.

Keywords: asthma & early wheeze; bronchiolitis; economic evaluation; epidemiology

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