ArticleBMJ paediatrics open2024
Identifying serious underlying diagnoses among patients with brief resolved unexplained events (BRUEs): a Canadian cohort study.
Article in BMJ paediatrics open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Prospective evaluation of clinical prediction rules for brief resolved unexplained event.Journal of pediatric gastroenterology and nutrition · 2026Article
- Etiology of apneic episodes in infants aged <1 year and validation of brief resolved unexplained events risk-stratification criteria without age as a risk factor.Frontiers in pediatrics · 2026Article
- Interhospital variation in the management of Brief Resolved Unexplained Events (BRUE) in infants: A Canadian multicenter cohort study.Journal of hospital medicine · 2025Observational
- External Validation of Brief Resolved Unexplained Events Prediction Rules for Serious Underlying Diagnosis.JAMA pediatrics · 2025Article
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Authors and funding
30 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo describe the demographics and clinical outcomes of infants with brief resolved unexplained events (BRUE).
designA retrospective cohort study.
setting11 centres within the Canadian Paediatric Inpatient Research Network. PATIENTS: Patients presenting to the emergency department (ED) following a BRUE (2017-2021) were eligible, when no clinical cause identified after a thorough history and physical examination.
main outcome measuresSerious underlying diagnosis (requiring prompt identification) and event recurrence (within 90 days).
resultsOf 1042 eligible patients, 665 were hospitalised (63.8%), with a median stay of 1.73 days. Diagnostic tests were performed on 855 patients (82.1%), and 440 (42.2%) received specialist consultations. In total, 977 patients (93.8%) were categorised as higher risk BRUE per the American Academy of Pediatrics guidelines. Most patients (n=551, 52.9%) lacked an explanatory diagnosis; however, serious underlying diagnoses were identified in 7.6% (n=79). Epilepsy/infantile spasms were the most common serious underlying diagnoses (2.0%, n=21). Gastro-oesophageal reflux was the most common non-serious underlying diagnosis identified in 268 otherwise healthy and thriving infants (25.7%). No instances of invasive bacterial infections, arrhythmias or metabolic disorders were found. Recurrent events were observed in 113 patients (10.8%) during the index visit, and 65 patients had a return to ED visit related to a recurrent event (6.2%). One death occurred within 90 days.
conclusionsThere is a low risk for a serious underlying diagnosis, where the majority of patients remain without a clear explanation. This study provides evidence-based risk for adverse outcomes, critical information to be used when engaging in shared decision-making with caregivers.
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