WIP 9 - Yield of Diagnostic Testing and Specialty Consultation among Infants Presenting with a Brief Resolved Unexplained Event

Poster Number: WIP 9
Publication Number: WIP 9.969

Background: Brief Resolved Unexplained Episodes (BRUE) commonly present in infants. Infrequently, they can indicate a serious underlying condition. Given the heightened concern among caregivers and healthcare providers, these infants are frequently admitted for diagnostic evaluations

Objective: To describe the rate and yield of common diagnostic testing (e.g., bloodwork and imaging) and consultations among infants with BRUE.

Design/Methods: This was a retrospective cohort study performed at 11 Canadian hospitals affiliated with the Pediatric Inpatient Research Network (PIRN). The study received approval from the Research Ethics Board at BC Children’s Hospital. A total of 1042 infants with BRUE between 2017-2021, were included. Detailed data on diagnostic tests, specialty consultations or the involvement of allied healthcare providers were collected, noting whether they were normal/abnormal and if they contributed to the diagnosis. We also included imaging, ancillary testing or consultations conducted in the outpatient setting within 90 days of presentation. Among results noted to be outside the reference range, we indicated whether a test provided an explanatory diagnosis for the BRUE, or only revealed incidental or non-clinically significant findings. The term “incidental findings” referred to test results revealing abnormalities unrelated to the BRUE, prompting additional investigations, consultations, follow-ups, or repeat testing. “Non-clinically significant findings” represented instances where the test results, while deemed abnormal, did not influence the subsequent management of the patient.
Diagnostic evaluations were conducted for 855 patients (82.1%), providing an explanatory diagnosis in 74 (8.7%), while 552 (64.6%) only had incidental or non-clinically significant findings. Overall, 440 patients (42.2%) underwent specialist consultations, providing an explanatory diagnosis in 122 patients (27.7%) and incidental findings in 70 (15.9%). Detailed review of each diagnostic test and specialty consultation in terms of rate and yield is underway. Data collection has concluded.