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Apparent Life-Threatening Events: Patients' Health Status at 5 Years of Age
Insights
A single apparent life-threatening event (ALTE) in infancy did not predict long-term health issues. Most children evaluated for ALTE were healthy at age 5, with few developing chronic or neurological conditions.
Area of Science:
- Pediatrics
- Child Health
- Clinical Outcomes
Background:
- The long-term health implications of apparent life-threatening events (ALTE) in infants remain under-researched.
- Understanding the sequelae of ALTE is crucial for accurate prognosis and parental counseling.
Purpose of the Study:
- To assess the health status of children diagnosed with ALTE during infancy at approximately 5 years of age.
- To determine if an initial ALTE diagnosis correlates with long-term health conditions.
Main Methods:
- A cohort of 132 infants diagnosed with ALTE were followed until age 5.
- Diagnostic workups were categorized as 'broad' (covering five major causes) or 'narrow'.
- Health status at age 5 was determined through hospital records, community clinics, and parental reports.
Main Results:
- Choking was the most frequent ALTE presentation (49.2%).
- At age 5, 56.8% of children were healthy, while 27.3% had unrelated chronic conditions.
- 15.9% had unrelated neurodevelopmental issues, primarily attention deficit disorder; one child developed epilepsy.
Conclusions:
- A single apparent life-threatening event in infancy is not predictive of chronic systemic or neurological diseases by age 5.
- The study suggests that most infants experiencing ALTE do not face significant long-term health detriments related to the event.
Background:
The long-term significance of apparent life-threatening events (ALTE) has not been thoroughly studied.
Objectives:
To evaluate, at age 5 years, the health status of consecutive children diagnosed with ALTE in infancy.
Methods:
Based on the diagnostic workup, patients were classified into two groups: a 'broad' evaluation group (at least one test/procedure related to each of the five main causes: infectious, metabolic, cardiopulmonary, gastroenterological, neurological), and a 'narrow' workup group whose evaluation did not cover all five domains. Health status around age 5 was obtained from hospital records, community clinics and parents/caregivers.
Results:
We identified 132 children with ALTE. Choking (49.2%) was the most common description, followed by apnea (13.6%), suspected seizure (12.9%), cyanosis (12.1%), breath-holding spell (8.3%), and pallor (3.8%). A broad diagnostic workup was performed in 62.1% of the infants, and a narrow workup in 37.9%. At age 5 years, 56.8% of the children were healthy; 27.3% reported chronic conditions unrelated to ALTE. Twenty-one children (15.9%) had unrelated neurodevelopmental conditions, mostly attention deficit disorder. One of the 132 ALTE patients relapsed and was eventually diagnosed with epilepsy.
Conclusions:
A single episode of ALTE in infancy was neither predictive of nor associated with chronic systemic or neurological-disease at age 5 years.
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