Observational studyJournal of hospital medicine2025
Interhospital variation in the management of Brief Resolved Unexplained Events (BRUE) in infants: A Canadian multicenter cohort study.
Observational study in Journal of hospital medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The trial behind it
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Who cites it
1 citing paper in PubMed.
- Interhospital variation in the management of Brief Resolved Unexplained Events (BRUE) in infants: A Canadian multicenter cohort study.Journal of hospital medicine · 2025Observational
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Authors and funding
19 authors.
Funding
Abstract
backgroundGuidelines on Brief Resolved Unexplained Event (BRUE) only provide recommendations for infants categorized at lower risk. However, most infants fall into the higher-risk category, leaving management decisions to individual clinicians and contributing to variation in care.
objectivesDescribe interhospital variation in BRUE management and determine whether higher resource utilization improves detection of serious underlying diagnoses.
methodsThis multicenter observational cohort (2017-2021) included infants (< 12 months) with BRUE at eight Canadian hospitals. We recorded admission, and use of electrocardiograms (ECG), electroencephalograms (EEG), antibiotic and anti-reflux medications, and subspecialty consultations. Multivariable median regression evaluated the association between tests/interventions and length of stay (LOS), and logistic regression assessed whether site-level resource use correlated with serious underlying diagnoses detection.
resultsOf 758 infants (92% higher-risk), we noted variation in admission rates (32%-76%, p < .001), ICU admissions (0%-20%, p < .001), median LOS (0.8-2.0 days, p < .001), ECG (24%-78%, p < .001), EEG (8%-29%, p = .001), and anti-reflux medication (0%-21%, p < .001). Five percent had a serious underlying diagnosis, with no significant site differences (0%-8%, p = .49). Median regression showed EEG (19.9 h, 95% CI: 6.8-33.0, p = .03), empiric antibiotics (15.8 h, 95% CI: 4.7-26.9, p = .03), and subspecialty consultation (17.0 h, 95% CI: 10.8-23.2, p < .001) were associated with longer LOS. Higher resource use did not increase detection of serious underlying diagnoses.
conclusionsSubstantial variation exists in BRUE management, associated with prolonged LOS. Higher admission and testing were not associated with increased detection of serious underlying diagnoses. These findings highlight the need for standardized care approaches.
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