ArticleJournal of pediatric gastroenterology and nutrition2025
A prospective study of diagnostic testing and hospital charges after brief resolved unexplained event.
Article in Journal of pediatric gastroenterology and nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The trial behind it
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Who cites it
6 citing papers in PubMed.
- Association Between Salivary Substance P and Aspiration on Videofluoroscopic Swallow Study in Infants and Toddlers.The Journal of pediatrics · 2026Article
- Hospital costs for infants with brief resolved unexplained events given a diagnosis of gastroesophageal reflux disease.Journal of pediatric gastroenterology and nutrition · 2026Article
- Prospective evaluation of clinical prediction rules for brief resolved unexplained event.Journal of pediatric gastroenterology and nutrition · 2026Article
- Gatherings in Esophagology: Innovations and Future Directions in the Diagnosis and Management of Reflux Disease.Annals of the New York Academy of Sciences · 2026Article
- Thickened Liquids Improve Infant Swallow Function as Measured by Penetration-Aspiration Scale Score on Videofluoroscopic Swallow Study.Pediatric pulmonology · 2025Article
- Outcomes for infants with BRUE diagnosed with oropharyngeal dysphagia or gastroesophageal reflux disease: a multicenter study from the Pediatric Health Information System Database.European journal of pediatrics · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectivesTo evaluate diagnostic testing frequency/yield and determine drivers of hospital charges in a prospective cohort of infants with brief resolved unexplained event (BRUE) to test the hypothesis that length of stay (LOS), low-yield diagnostic testing, and repeat hospital visits increase costs.
methodsWe conducted a prospective cohort study of infants admitted after BRUE to determine how clinical practice impacts the cost of care. Charge data from our institution's billing records database included room and board, diagnostics, medications, and professional fees for index hospitalizations and 6-month follow-ups. Charts were reviewed for clinical data, testing results, and repeat hospitalizations. Parent-reported symptoms and management changes were obtained by questionnaires. Multivariable analyses with linear regression were conducted to determine risk factors for hospitalization charges and total charges including hospitalization and 6-month follow-up.
resultsThe cohort included 155 subjects with median index hospitalization charges of $11,256 and total charges of $15,675. Overall, 76% had persistent BRUE symptoms and 15% repeat hospitalization; 34% were treated with acid suppression. Only 9.7% of the tests performed provided a potential diagnosis, but the videofluoroscopic swallow study (VFSS) had the highest yield with 70% abnormal. On multivariable analysis, LOS, VFSS, flexible laryngoscopy, electroencephalogram, and repeat hospital visits were all associated with increased charges (fold change: 142%-354%).
conclusionsHospitalization and follow-up care are costly after BRUE. Potentially modifiable drivers of charges include test number, LOS, and repeat hospital visits. Most testing is low-yield, but timely performance of VFSS may allow for cost-effective and appropriate treatment of oropharyngeal dysphagia and prevention of persistent symptoms. Gastroenterologists are frequently involved in caring for these children and are uniquely positioned to help guide testing and treatment related to gastroesophageal reflux disease and oropharyngeal dysphagia.
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