Explanatory Diagnoses Following Hospitalization for a Brief Resolved Unexplained Event

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.