Nassr Nama, Amy DeLaroche, Joshua L Bonkowsky, David Gremse, Joel S Tieder
{"title":"Brief Resolved Unexplained Event: Evidence-Based and Family-Centered Management.","authors":"Nassr Nama, Amy DeLaroche, Joshua L Bonkowsky, David Gremse, Joel S Tieder","doi":"10.1542/pir.2024-006351","DOIUrl":null,"url":null,"abstract":"<p><p>Brief resolved unexplained events (BRUEs) are frequently encountered in infants younger than 1 year. By definition, these events require the infant to be asymptomatic and at baseline at the time of presentation, with no significant abnormalities on examination and no discernible explanatory diagnosis. Research has shown that less than 5% of BRUE cases are attributable to serious underlying conditions, with no increased mortality risk and no increased risk of sudden infant death syndrome. Despite these findings, approximately 63% of patients with BRUEs are hospitalized and up to 82% undergo diagnostic tests, which predominantly result in false-positive findings. Such results may lead to unnecessarily prolonged hospital stays, additional tests or consultations, and increased parental anxiety. The management of a patient who has experienced a BRUE can be challenging for providers and parents alike. Although risk is known to be low in these infants, providers may be compelled to explain the event and provide reassurance. Caregivers oftentimes are concerned that the events may reoccur and be a harbinger of a missed diagnosis. Shared decision-making can be used to explain risk and the benefit of additional testing and hospitalization. This family-centered strategy can align care with the family's values, provide reassurance, and decrease decisional conflict.</p>","PeriodicalId":20007,"journal":{"name":"Pediatrics in review","volume":"45 10","pages":"560-572"},"PeriodicalIF":1.2000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatrics in review","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1542/pir.2024-006351","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Brief resolved unexplained events (BRUEs) are frequently encountered in infants younger than 1 year. By definition, these events require the infant to be asymptomatic and at baseline at the time of presentation, with no significant abnormalities on examination and no discernible explanatory diagnosis. Research has shown that less than 5% of BRUE cases are attributable to serious underlying conditions, with no increased mortality risk and no increased risk of sudden infant death syndrome. Despite these findings, approximately 63% of patients with BRUEs are hospitalized and up to 82% undergo diagnostic tests, which predominantly result in false-positive findings. Such results may lead to unnecessarily prolonged hospital stays, additional tests or consultations, and increased parental anxiety. The management of a patient who has experienced a BRUE can be challenging for providers and parents alike. Although risk is known to be low in these infants, providers may be compelled to explain the event and provide reassurance. Caregivers oftentimes are concerned that the events may reoccur and be a harbinger of a missed diagnosis. Shared decision-making can be used to explain risk and the benefit of additional testing and hospitalization. This family-centered strategy can align care with the family's values, provide reassurance, and decrease decisional conflict.
期刊介绍:
Pediatrics in Review (PIR) is the American Academy of Pediatrics’ monthly peer-reviewed continuing medical education journal, designed to keep the general pediatric clinician current in all areas of pediatric medicine and to assist those participating in the Maintenance of Certification program of the American Board of Pediatrics (ABP).
The journal is one of the key components of the Academy’s continuing medical education program: PREP® (the Pediatrics Review and Education Program). Together, PIR and the PREP Self-Assessment comprise PREP The Curriculum®.
Each PIR review article includes quiz questions formulated by topic experts.