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Explanatory Diagnoses Following Hospitalization for a Brief Resolved Unexplained Event

Risa Bochner1, Joel S Tieder2,3, Erin Sullivan3

  • 1State University of New York Downstate Health Sciences University and Department of Pediatrics, New York City Health and Hospitals Kings County, Brooklyn, New York bochnerr@nychhc.org.

Pediatrics
|October 5, 2021
PubMed

Insights

Most infants hospitalized for brief resolved unexplained events (BRUE) do not receive a diagnosis during their hospital stay. Further research is needed to identify which infants benefit most from hospitalization for BRUE evaluation.

Area of Science:

  • Pediatrics
  • Emergency Medicine
  • Neonatology

Background:

  • Hospitalization is common for young infants presenting with brief resolved unexplained events (BRUE) to the emergency department (ED).
  • The diagnostic yield of hospitalization for BRUE in infants without an initial explanatory diagnosis is not well-established.

Purpose of the Study:

  • To determine the rate of explanatory diagnoses identified during hospitalization for infants with BRUE.
  • To investigate factors associated with identifying an explanatory diagnosis during hospitalization.

Main Methods:

  • Multicenter retrospective cohort study of infants hospitalized with BRUE.
  • Inclusion criteria: infants without an explanatory diagnosis at admission.
  • Data collected on diagnostic testing, consultations, and observed events during hospitalization.

Main Results:

  • 37.0% of 980 infants received an explanatory diagnosis during hospitalization.
  • Diagnostic testing, consultations, or observed events contributed to diagnosis in only 17.9% of cases.
  • Serious diagnoses were identified in 1.5% of infants, most commonly seizures.

Conclusions:

  • The majority of hospitalizations for BRUE do not yield an explanatory diagnosis.
  • Most identified diagnoses are benign or self-limited.
  • Further research is required to optimize hospitalization criteria for BRUE evaluation.
Abstract

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