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Mortality after discharge in clinically stable infants admitted with a first-time apparent life-threatening event

Shruti Kant1, Jay D Fisher, David G Nelson

  • 1Department of Pediatric Emergency Medicine, University of Alabama-Birmingham School of Medicine, Birmingham, AL, USA.

The American Journal of Emergency Medicine
|February 13, 2013
PubMed

Insights

Infants admitted for apparent life-threatening events (ALTE) face a significant risk of post-discharge mortality, with two deaths occurring within two weeks of their emergency department visit. Emergency physicians should consider routine admission for these patients.

Area of Science:

  • Pediatric Emergency Medicine
  • Neonatal Care
  • Clinical Outcomes Research

Background:

  • Apparent life-threatening events (ALTE) are a common reason for pediatric emergency department visits.
  • Understanding post-discharge mortality risk in infants with ALTE is crucial for clinical management.

Purpose of the Study:

  • To investigate the mortality rate in clinically stable infants after hospital discharge following their first apparent life-threatening event (ALTE).

Main Methods:

  • A retrospective chart review was conducted on infants aged 0-6 months presenting with their first ALTE over a 5-year period.
  • Inclusion criteria were applied, and physician reviewers assessed patient charts.
  • Mortality data was cross-referenced with county death records and hospital records.

Main Results:

  • Of 176 infants meeting inclusion criteria, 1.1% (2 patients) died post-discharge, both within two weeks of their emergency department visit.
  • Neither of the deceased infants had positive diagnostic evaluations during their emergency department stay.
  • Pneumonia was identified as the cause of death in both fatalities.

Conclusions:

  • Infants admitted to the hospital for an apparent life-threatening event (ALTE) have a substantial risk of subsequent mortality.
  • Routine hospital admission should be considered by emergency physicians for infants presenting with ALTE.
Abstract

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