{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T11:23:00Z","timestamp":1769512980955,"version":"3.49.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>In 2016, brief resolved unexplained events (BRUEs) were proposed as alternative concepts to apparent life-threatening event (ALTE). The clinical utility of managing ALTE cases according to the BRUE classification is controversial. To verify the clinical utility of the BRUE criteria, we evaluated the proportion of ALTE patients who met and those who did not meet the BRUE criteria and assessed the diagnoses and outcomes of each group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We retrospectively investigated patients with ALTE younger than 12 months who visited the emergency department of the National Center for Child Health and Development from April 2008 to March 2020. The patients were classified into the higher-risk and lower-risk BRUE groups; however, those who did not meet the BRUE criteria were classified into the ALTE-not-BRUE group. We evaluated the diagnoses and outcomes of each group. Adverse outcomes included death, recurrence, aspiration, choking, trauma, infection, convulsions, heart disease, metabolic disease, allergies, and others.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Over the period of 12 years, a total of 192 patients were included, among which 140 patients (71%) were classified into the ALTE-not-BRUE group, 43 (22%) into the higher-risk BRUE group, and 9 (5%) into the lower-risk BRUE group. Adverse outcomes occurred in 27 patients in the ALTE-not-BRUE group and 10 patients in the higher-risk BRUE group. No adverse outcome occurred in the lower-risk BRUE group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Many of the patients with ALTE were classified into the ALTE-not-BRUE group, suggesting that replacing ALTE with BRUE is difficult. Although patients classified as lower-risk BRUE showed no adverse outcomes, there were only a few of them. In the pediatric emergency medicine setting, the BRUE risk classification may be beneficial for certain patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002986","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T16:00:42Z","timestamp":1686844842000},"page":"507-510","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Utility and Patient Distribution of Brief Resolved Unexplained Event Classification for Apparent Life-Threatening Events"],"prefix":"10.1097","volume":"39","author":[{"given":"Daiki","family":"Tanaka","sequence":"first","affiliation":[{"name":"Division of Emergency and Transport Services"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Amagasa","sequence":"additional","affiliation":[{"name":"Division of Emergency and Transport Services"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanae","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Division of Emergency and Transport Services"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryuji","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Division of Emergency and Transport Services"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoko","family":"Uematsu","sequence":"additional","affiliation":[{"name":"Division of Emergency and Transport Services"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Tsuji","sequence":"additional","affiliation":[{"name":"Division of Emergency and Transport Services"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuru","family":"Kubota","sequence":"additional","affiliation":[{"name":"General Pediatrics & Interdisciplinary Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Critical Care Medicine, National Center for Child Health and Development, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1542\/peds.79.2.292","article-title":"National Institutes of Health consensus development conference on infantile apnea and home monitoring, Sept 29 to Oct 1, 1986","volume":"79","year":"1987","journal-title":"Pediatrics"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.1001\/jama.285.17.2199","article-title":"Cardiorespiratory events recorded on home monitors: comparison of healthy infants with those at increased risk for SIDS","volume":"285","year":"2001","journal-title":"JAMA"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1136\/emj.19.1.11","article-title":"Apparent life threatening events in infants presenting to an emergency department","volume":"19","year":"2002","journal-title":"Emerg Med J"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1097\/PEC.0b013e31825cf576","article-title":"A clinical decision rule to identify infants with apparent life-threatening event who can be safely discharged from the emergency department","volume":"28","year":"2012","journal-title":"Pediatr Emerg Care"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/00006565-199906000-00009","article-title":"Apparent life-threatening events presenting to a pediatric emergency department","volume":"15","year":"1999","journal-title":"Pediatr Emerg Care"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.jpeds.2007.11.024","article-title":"Variation in inpatient resource utilization and management of apparent life-threatening events","volume":"152","year":"2008","journal-title":"J Pediatr"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"e20160590","DOI":"10.1542\/peds.2016-0590","article-title":"Subcommittee on Apparent Life Threatening Events. Brief resolved unexplained events (formerly apparent life-threatening events) and evaluation of lower-risk infants","volume":"137","year":"2016","journal-title":"Pediatrics"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/j.acap.2019.08.001","article-title":"Brief resolved unexplained events: analysis of an apparent life threatening event database","volume":"19","year":"2019","journal-title":"Acad Pediatr"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1542\/hpeds.2018-0044","article-title":"Retrospective application of BRUE criteria to patients presenting with ALTE","volume":"8","year":"2018","journal-title":"Hosp Pediatr"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1002\/ppul.24195","article-title":"Brief resolved unexplained events: retrospective validation of diagnostic criteria and risk stratification","volume":"54","year":"2019","journal-title":"Pediatr Pulmonol"},{"key":"bib11-20250504","first-page":"1170","article-title":"Patient distribution of brief resolved unexplained event classification for apparent life-threatening events","volume":"125","year":"2021","journal-title":"J Jpn Pediatr Soc"},{"key":"bib12-20250504","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1007\/s00431-017-2855-6","article-title":"Independent risk factors for recurrence of apparent life-threatening events in infants","volume":"176","year":"2017","journal-title":"Eur J Pediatr"},{"key":"bib13-20250504","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1097\/PEC.0000000000001816","article-title":"Long-term follow-up of infants after a brief resolved unexplained event\u2013related hospitalization","volume":"35","year":"2019","journal-title":"Pediatr Emerg Care"},{"key":"bib14-20250504","doi-asserted-by":"crossref","first-page":"e2020036095","DOI":"10.1542\/peds.2020-036095","article-title":"Risk factors and outcomes after a brief resolved unexplained event: a multicenter study","volume":"148","year":"2021","journal-title":"Pediatrics"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002986","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:09:06Z","timestamp":1746382146000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002986"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":14,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000002986","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2023,7]]}}}