{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:40:21Z","timestamp":1792176021872,"version":"4.4.0"},"reference-count":19,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T00:00:00Z","timestamp":1734912000000},"content-version":"unspecified","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Alberta Children's Hospital Foundation","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Alberta Medical Association Medical Services Budget Innovation Fund","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MCT-63141"],"award-info":[{"award-number":["MCT-63141"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,11,15]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Although croup is a common respiratory illness, there is little published regarding symptom course. We aimed to assess symptom progression and caregiver burden, and whether age, sex or season and initial severity of disease are associated with symptom duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting and participants<\/jats:title>\n                    <jats:p>We conducted a secondary analysis of two Canadian prospective cohorts of children 0\u201316 years old diagnosed with croup; one recruited from a paediatric emergency department (ED) (307 children) between November 1999 and March 2000, and the other from 26 general EDs (1214 children) between September 2002 and April 2006. Baseline data included age, sex, season, corticosteroid treatment and clinical severity score based on the presence or absence of a barky cough, stridor at rest or with agitation and chest wall indrawing (mild, moderate or severe). For both cohorts, the child\u2019s primary caregiver was telephoned daily to collect symptom progression and psychosocial data (caregiver stress, lost sleep and work) until the child was symptom-free for over 24 hours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The paediatric and general ED cohorts are reported separately; croup symptoms peaked at initial ED presentation for 96% and 77%, respectively. The longest-lived symptom was a barky cough, resolving by 34 and 47 hours for 50%, and 78 and 119 hours for 90% of children, respectively. Neither sex nor severity at presentation were significantly associated with symptom duration in either cohort. Season of illness was associated in both; age was associated in the general but not the paediatric ED cohort. The primary caregiver lost a mean (SD) of 4.1 (4.9) and 2.8 (4.7) hours of sleep during the illness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most children with croup presented for care at the peak of symptom severity. Symptoms resolved for half of the children in 1.5\u20132\u2009days and for 90% in 3\u20135\u2009days after presentation. Caregivers experienced a significant loss of sleep.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-080102","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T00:55:20Z","timestamp":1735001720000},"page":"e080102","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Duration, course and caregiver burden of croup in children: two observational cohorts"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9279-2273","authenticated-orcid":false,"given":"Candice Leigh","family":"Bjornson","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada"},{"name":"Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6604-0652","authenticated-orcid":false,"given":"Alberto","family":"Nettel-Aguirre","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (Adjunct), Faculty of Engineering and Information Services, School of Mathematics and Applied Statistics, University of Wollongong, Wollongong, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janielee","family":"Williamson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8453-7849","authenticated-orcid":false,"given":"David W","family":"Johnson","sequence":"additional","affiliation":[{"name":"Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada"},{"name":"Departments of Pediatrics, Emergency Medicine, and Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,12,23]]},"reference":[{"key":"2025121602415307000_14.12.e080102.1","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1542\/peds.71.6.871","article-title":"Croup: an 11-year study in a pediatric practice","volume":"71","author":"Denny","year":"1983","journal-title":"Pediatrics"},{"key":"2025121602415307000_14.12.e080102.2","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1093\/oxfordjournals.aje.a113249","article-title":"The epidemiology of tracheobronchitis in pediatric practice","volume":"114","author":"Chapman","year":"1981","journal-title":"Am J Epidemiol"},{"key":"2025121602415307000_14.12.e080102.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.f7027","article-title":"Duration of symptoms of respiratory tract infections in children: systematic 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three methods of disseminating practice guidelines for children with croup [ISRCTN73394937]","volume":"1","author":"Johnson","year":"2006","journal-title":"Impl Sci"},{"key":"2025121602415307000_14.12.e080102.9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"2025121602415307000_14.12.e080102.10","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1978.02120300044008"},{"key":"2025121602415307000_14.12.e080102.11","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0b013e3181db2262"},{"key":"2025121602415307000_14.12.e080102.12","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1097\/PEC.0000000000000099","article-title":"Does active dissemination of evidence result in faster knowledge transfer than passive diffusion?: An analysis of trends of the management of pediatric asthma and croup in US emergency departments from 1995 to 2009","volume":"31","author":"Knapp","year":"2015","journal-title":"Pediatr Emerg 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