Nama et al reported a number of findings that can help to identify a pediatric patient who may need more aggressive management following a brief resolved unexplained event (BRUE). The authors are from multiple institutions in the United Stages and Canada belonging to the Brief Resolved Unexplained Event Research and Quality Improvement Network
Patient selection: age < 1 year with discharge diagnosis of ALTE or BRUE
Occurrence of serious underlying disease and/or recurrence: 17%
Predictors of severe underlying diagnosis from multivariate analysis:
(1) history of a previous similar event (aOR 1.8)
(2) abnormal medical history (aOR 1.9)
(3) age in days (aOR 1.003 per day)
|
Parameter
|
Beta-Coefficient
|
|
history of similar event
|
0.56
|
|
abnormal medical history
|
0.65
|
|
age in days
|
0.0025 * (day)
|
|
intercept
|
-3.75
|
Predictors of event recurrence from multivariate analysis:
(1) prematurity (aOR 1.6; < 32 weeks OR between 32-28 weeks and corrected to < 45 weeks)
(2) history of previous similar event (aOR 1.8)
(3) history of multiple events or event clusters (aOR 3.2)
(4) color changes (aOR 1.4)
(5) abnormal respiratory pattern (aOR 0.7)
(6) change in tone (aOR 0.7)
|
Parameter
|
Beta-Coefficient
|
|
prematurity
|
0.46
|
|
history of similar event
|
0.58
|
|
multiple events/cluster
|
1.17
|
|
color change
|
0.36
|
|
abnormal respirations
|
-0.32
|
|
change in tone
|
-0.31
|
|
intercept
|
-2.44
|
Additional factors associated with event recurrence:
(1) abnormal medical history
(2) age <= 60 days
