{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T05:51:04Z","timestamp":1791611464049,"version":"4.3.4"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008459","name":"University of Calgary","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008459","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005295","name":"American Academy of Pediatrics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005295","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Guidelines on Brief Resolved Unexplained Event (BRUE) only provide recommendations for infants categorized at lower risk. However, most infants fall into the higher\u2010risk category, leaving management decisions to individual clinicians and contributing to variation in care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Describe interhospital variation in BRUE management and determine whether higher resource utilization improves detection of serious underlying diagnoses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter observational cohort (2017\u20132021) included infants (&lt;\u200912 months) with BRUE at eight Canadian hospitals. We recorded admission, and use of electrocardiograms (ECG), electroencephalograms (EEG), antibiotic and anti\u2010reflux medications, and subspecialty consultations. Multivariable median regression evaluated the association between tests\/interventions and length of stay (LOS), and logistic regression assessed whether site\u2010level resource use correlated with serious underlying diagnoses detection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 758 infants (92% higher\u2010risk), we noted variation in admission rates (32%\u201376%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), ICU admissions (0%\u201320%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), median LOS (0.8\u20132.0 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), ECG (24%\u201378%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), EEG (8%\u201329%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.001), and anti\u2010reflux medication (0%\u201321%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Five percent had a serious underlying diagnosis, with no significant site differences (0%\u20138%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.49). Median regression showed EEG (19.9\u2009h, 95% CI: 6.8\u201333.0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.03), empiric antibiotics (15.8\u2009h, 95% CI: 4.7\u201326.9,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.03), and subspecialty consultation (17.0\u2009h, 95% CI: 10.8\u201323.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) were associated with longer LOS. Higher resource use did not increase detection of serious underlying diagnoses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Substantial 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jhm.70094","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T23:55:29Z","timestamp":1750982129000},"page":"1297-1305","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Interhospital variation in the management of Brief Resolved Unexplained Events (BRUE) in infants: A Canadian multicenter cohort study"],"prefix":"10.1002","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0199-3599","authenticated-orcid":false,"given":"Nassr","family":"Nama","sequence":"first","affiliation":[{"name":"Seattle Children's Hospital, Department of Pediatrics, Division of Hospital Medicine University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara","family":"Picco","sequence":"additional","affiliation":[{"name":"Hospital for Sick Children University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polina","family":"Kyrychenko","sequence":"additional","affiliation":[{"name":"Hospital for Sick Children University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey N.","family":"Bone","sequence":"additional","affiliation":[{"name":"BC Children's Hospital Research Institute Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Quet","sequence":"additional","affiliation":[{"name":"CHEO, Department of Pediatrics University of Ottawa Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2471-0432","authenticated-orcid":false,"given":"Jessica L.","family":"Foulds","sequence":"additional","affiliation":[{"name":"Stollery Children's Hospital, Department of Pediatrics, Division of Pediatric Hospital Medicine, Faculty of Medicine &amp; Dentistry University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9e Anne","family":"Gagnon","sequence":"additional","affiliation":[{"name":"CHU de Qu\u00e9bec Universit\u00e9 Laval Qu\u00e9bec City Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Novak","sequence":"additional","affiliation":[{"name":"Alberta Children's Hospital, Department of Pediatrics University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Parisien","sequence":"additional","affiliation":[{"name":"CHU Sainte\u2010Justine, Department of Pediatrics Universit\u00e9 de Montr\u00e9al Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Donlan","sequence":"additional","affiliation":[{"name":"MUHC\u2014The Montreal Children's Hospital McGill University Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran D.","family":"Goldman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Clinical Pharmacology and Emergency Medicine, BC Children's Hospital University of British Columbia Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anupam","family":"Sehgal","sequence":"additional","affiliation":[{"name":"Kingston General Hospital, Department of Paediatrics Queen's University Kingston Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronik","family":"Kanani","sequence":"additional","affiliation":[{"name":"North York General Hospital, Department of Pediatrics University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Holland","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of General Pediatrics IWK Health Centre Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0487-5835","authenticated-orcid":false,"given":"Sanjay","family":"Mahant","sequence":"additional","affiliation":[{"name":"Hospital for Sick Children University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7297-8348","authenticated-orcid":false,"given":"Eric","family":"Coon","sequence":"additional","affiliation":[{"name":"Seattle Children's Hospital, Department of Pediatrics, Division of Hospital Medicine University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel S.","family":"Tieder","sequence":"additional","affiliation":[{"name":"Seattle Children's Hospital, Department of Pediatrics, Division of Hospital Medicine University of Washington Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6253-1312","authenticated-orcid":false,"given":"Peter J.","family":"Gill","sequence":"additional","affiliation":[{"name":"Hospital for Sick Children University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The Canadian BRUE Collaboration (C\u2010BRUE\u2010C) and the Canadian Paediatric Inpatient Research Network (PIRN)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/pir.2024-006351"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000003277"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-0590"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.12.086"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2024.4399"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-036095"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/life11020171"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(24)01137-5"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2021-005805"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2022-006637"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","unstructured":"NamaN RajasegaranPJ McDanielLM et al. 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