What is the prevalence of brief resolved unexplained events (BRUEs) (apparent life-threatening events) (ALTEs)?

Updated: Feb 28, 2019
  • Author: Patrick L Carolan, MD; Chief Editor: Girish D Sharma, MD, FCCP, FAAP  more...
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Because of marked variability in the clinical presentations of brief resolved unexplained events (BRUEs), the true frequency is unknown.

The estimated frequency of apparent life-threatening events among healthy term infants widely varies (0.5–6% of all newborns), reflecting figures derived from older retrospective reviews of hospital records. [4]

A systematic review reported that apparent life-threatening events accounted for 0.6-0.8% of all emergency department visits among children younger than 1 year, was noted in 2.27% of hospitalized children, and had an incidence of 0.6 cases per 1,000 live-born infants. [5]

A prospective population-based study of apparent life-threatening events conducted in Austria reported an incidence of 2.46 cases per 1,000 live births. [6]  A population based infant cohort in Italy suggesting a cumulative incidence of 4.1 per 1,000 live births in the study area. [40]

Esani et al (2008) compared the epidemiologic features of apparent life-threatening events and sudden infant death syndrome (SIDS). [7] Infants who experienced an apparent life-threatening event were younger at the time of clinical presentation. In this study, 74% of patients who experienced an apparent life-threatening event presented when younger than 2 months. By contrast, approximately 25% of SIDS victims are younger than 2 months at the time of death, according to several epidemiologic studies of SIDS. The apparent life-threatening event cohort also included more female infants and fewer infants who were small for gestational age and who had low birth weight when compared with infants who experienced SIDS in other studies. The risk of subsequent death in the apparent life-threatening event group was 0.6%.

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