Brief Resolved Unexplained Event: Evidence-Based and Family-Centered Management

Area of Science:

• Pediatrics
• Emergency Medicine
• Clinical Practice

Background:

• Brief resolved unexplained events (BRUEs) are common in infants <1 year.
• BRUEs present with sudden, brief changes without clear cause, with infants returning to baseline.
• Serious underlying conditions account for <5% of BRUE cases, with no increased mortality or SIDS risk.

Purpose of the Study:

• To evaluate current management practices for BRUEs.
• To highlight the low risk associated with BRUEs despite frequent hospitalizations and testing.
• To advocate for shared decision-making in managing BRUEs.

Main Methods:

• Review of existing research on BRUEs.
• Analysis of diagnostic yield and outcomes of hospitalized BRUE patients.
• Exploration of shared decision-making as a management strategy.

Main Results:

• ~63% of BRUE patients are hospitalized, and up to 82% undergo diagnostic tests.
• Diagnostic tests for BRUEs often yield false-positive results.
• Unnecessary hospitalizations and tests increase costs, parental anxiety, and may prolong care.

Conclusions:

• BRUEs in infants have a low risk of serious underlying pathology.
• Current management often involves over-investigation and hospitalization.
• Shared decision-making can align care with family values, reduce anxiety, and decrease unnecessary medical interventions.