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Explanatory Diagnoses Following Hospitalization for a Brief Resolved Unexplained Event
Pediatrics ( IF 6.2 ) Pub Date : 2021-11-01 , DOI: 10.1542/peds.2021-052673
Risa Bochner 1 , Joel S Tieder 2, 3 , Erin Sullivan 3 , Matt Hall 4 , Allayne Stephans 5 , Manoj K Mittal 6 , Nidhi Singh 7 , Atima Delaney 8 , Beth Harper 8 , Nirav Shastri 9 , Daniela Hochreiter 10 , Mark I Neuman 8 ,
Affiliation  

BACKGROUND AND OBJECTIVES

Most young infants presenting to the emergency department (ED) with a brief resolved unexplained event (BRUE) are hospitalized. We sought to determine the rate of explanatory diagnosis after hospitalization for a BRUE.

METHODS

This was a multicenter retrospective cohort study of infants hospitalized with a BRUE after an ED visit between October 1, 2015, and September 30, 2018. We included infants without an explanatory diagnosis at admission. We determined the proportion of patients with an explanatory diagnosis at the time of hospital discharge and whether diagnostic testing, consultation, or observed events occurring during hospitalization were associated with identification of an explanatory diagnosis.

RESULTS

Among 980 infants hospitalized after an ED visit for a BRUE without an explanatory diagnosis at admission, 363 (37.0%) had an explanatory diagnosis identified during hospitalization. In 805 (82.1%) infants, diagnostic testing, specialty consultations, and observed events did not contribute to an explanatory diagnosis, and, in 175 (17.9%) infants, they contributed to the explanatory diagnosis (7.0%, 10.0%, and 7.0%, respectively). A total of 15 infants had a serious diagnosis (4.1% of explanatory diagnoses; 1.5% of all infants hospitalized with a BRUE), the most common being seizure and infantile spasms, occurring in 4 patients.

CONCLUSIONS

Most infants hospitalized with a BRUE did not receive an explanation during the hospitalization, and a majority of diagnoses were benign or self-limited conditions. More research is needed to identify which infants with a BRUE are most likely to benefit from hospitalization for determining the etiology of the event.



中文翻译:

短暂解决不明事件住院后的解释性诊断

背景和目标

大多数因短暂解决的不明原因事件 (BRUE) 到急诊科 (ED) 就诊的小婴儿住院。我们试图确定 BRUE 住院后的解释性诊断率。

方法

这是一项多中心回顾性队列研究,研究对象为 2015 年 10 月 1 日至 2018 年 9 月 30 日期间因 BRUE 住院的婴儿。我们纳入了入院时没有解释性诊断的婴儿。我们确定了出院时有解释性诊断的患者比例,以及住院期间发生的诊断测试、咨询或观察到的事件是否与解释性诊断的确定相关。

结果

在 980 名因 BRUE 就诊但入院时没有解释性诊断而住院的婴儿中,363 名(37.0%)在住院期间确定了解释性诊断。在 805 (82.1%) 名婴儿中,诊断测试、专科会诊和观察事件对解释性诊断没有贡献,在 175 (17.9%) 名婴儿中,它们对解释性诊断有贡献(7.0%、10.0% 和 7.0 %, 分别)。共有 15 名婴儿有严重诊断(占解释性诊断的 4.1%;在所有因 BRUE 住院的婴儿中占 1.5%),最常见的是癫痫发作和婴儿痉挛,发生在 4 名患者中。

结论

大多数因 BRUE 住院的婴儿在住院期间没有得到解释,大多数诊断是良性或自限性疾病。需要更多的研究来确定哪些患有 BRUE 的婴儿最有可能从住院中受益,以确定事件的病因。

更新日期:2021-11-01
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