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Resource Utilization for Brief Resolved Unexplained Events in a Pediatric and General Emergency Department
Daniel M Fein1,2, Leon Chen2,3, Nina Samuel4
1Department of Pediatrics, Division of Pediatric Emergency Medicine, Children's Hospital at Montefiore.
Pediatric Emergency Care
|September 11, 2025
Summary
Higher-risk brief resolved unexplained events (BRUE) underwent fewer diagnostic tests in general emergency departments (GED) compared to pediatric emergency departments (PED). This indicates opportunities to standardize BRUE testing and management across different emergency settings.
Area of Science:
- Pediatric Emergency Medicine
- Health Services Research
Background:
- Brief Resolved Unexplained Events (BRUE) require careful resource allocation in emergency departments.
- Risk stratification is crucial for managing BRUE and optimizing diagnostic testing.
Purpose of the Study:
- To compare diagnostic test utilization for lower-risk versus higher-risk BRUE.
- To analyze resource utilization differences between general (GED) and pediatric (PED) emergency departments for BRUE cases.
Main Methods:
- Retrospective chart review of BRUE cases over 6.5 years.
- Comparison of diagnostic test counts (laboratory, imaging, cardiovascular) between risk groups and ED types.
- Negative binomial regression to identify factors associated with increased BRUE testing.
Main Results:
- Higher-risk BRUE cases received more diagnostic tests than lower-risk cases overall.
- Fewer tests were performed for higher-risk BRUE in the GED compared to the PED.
- No significant difference in tests for lower-risk BRUE between GED and PED.
Conclusions:
- Significant variation exists in diagnostic testing for higher-risk BRUE between GED and PED.
- Opportunities to reduce testing variability and standardize management for BRUE cases.
- Most BRUE cases, regardless of risk, were admitted or transferred.
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