{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T10:25:22Z","timestamp":1769509522562,"version":"3.49.0"},"reference-count":0,"publisher":"SMW Supporting Association","issue":"4142","license":[{"start":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T00:00:00Z","timestamp":1634860800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Swiss Med Wkly"],"abstract":"<jats:p>AIMS OF THE STUDY:\u00a0Apparent life threatening events (ALTEs) are highly stressful situations for the caregiver and commonly result in presentation of the child to an emergency department. As the events are usually brief and resolve in a short period of time, the entity is now called a brief resolved unexplained event (BRUE). Updated recommendations have been published in recent years on the management of BRUE, including a risk stratification to identify those at lower risk for subsequent events or severe underlying disorders. The aim of this study was to describe the epidemiology of ALTE and BRUE at our hospital and detail clinical practice of management in this population in a tertiary care children\u2019s hospital in Switzerland.\n\n                        METHODS:\u00a0We retrospectively analysed all cases of children with an ALTE or BRUE admitted to the University Children\u2019s Hospital Basel between September 2009 and April 2018, identified using ICD-10GM coding. Electronic health records were used to extract data on diagnostic procedures, duration of admission and outcome. Infants with a lower-risk BRUE (defined as age &gt;60 days and &lt;1year, born at \u226532 weeks gestational age and postconceptional age \u226545 weeks, first BRUE episode with a duration of &lt;1 minute and no cardiopulmonary resuscitation\u00a0by trained medical provider required) were compared with those with a higher-risk BRUE\/ALTE (not fulfilling all the criteria for lower-risk BRUE).\nRESULTS:\u00a0A total of 65 patients with a median age of 42 days (interquartile\u00a0range 20\u201367) were identified, of whom 15%\u00a0were classified as having a lower-risk BRUE. A blood sample was analysed in 97% of patients, cranial ultrasound was performed in 63%, an electrocardiogram in 78% and polysomnography in 26%. The results  remained normal in almost all patients and none had a further event recorded during admission. In one patient only\u00a0QTc prolongation was detected as a potential serious underlying disease.\nCONCLUSIONS:\u00a0Our data show that admission for more than 24 hours and extensive investigations for infants admitted for an ALTE\/BRUE rarely led to identification of specific underlying causes. According to  current recommendations, 15% of the admitted patients could be categorised as having a lower-risk BRUE and therefore hospital admissions and investigations can safely be reduced. We propose an adaptation of the current Swiss recommendations for ALTE\/BRUE to optimise clinical management of children presenting with a\u00a0BRUE.<\/jats:p>","DOI":"10.4414\/smw.2021.w30026","type":"journal-article","created":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T16:11:42Z","timestamp":1634919102000},"page":"w30026","source":"Crossref","is-referenced-by-count":6,"title":["Apparent life-threatening events\u00a0and brief resolved unexplained events: management of children at a Swiss tertiary care center"],"prefix":"10.57187","volume":"151","author":[{"given":"Katrina S.","family":"Evers","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sven","family":"Wellmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgit C.","family":"Donner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Ritz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"36756","published-online":{"date-parts":[[2021,10,22]]},"container-title":["Swiss Medical Weekly"],"original-title":[],"link":[{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/download\/3086\/5136","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/download\/3086\/5137","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/download\/3086\/5136","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T14:53:58Z","timestamp":1764600838000},"score":1,"resource":{"primary":{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/view\/3086"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,22]]},"references-count":0,"journal-issue":{"issue":"4142","published-online":{"date-parts":[[2021,10,11]]}},"URL":"https:\/\/doi.org\/10.4414\/smw.2021.w30026","relation":{},"ISSN":["1424-3997"],"issn-type":[{"value":"1424-3997","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,22]]}}}