126 BRUE and evaluation of higher-risk infants with overnight oximetry
Notice bibliographique
Résumé
Abstract Primary Subject area Hospital Paediatrics Background BRUE (Brief resolved unexplained event) is a worrisome event for parents. Investigation guidelines for infants 2 months and older have been published, but an evaluation framework for higher-risk infants is still evolving. Objectives The goal of this study is to determine if an overnight oximetry for patients presenting with BRUE under the age of the 2 months would help to target patients at higher risk of recurrent BRUE. The secondary goals are to evaluate the characteristics of those infants, the rate of recurrence of BRUE and to evaluate the effectiveness of other investigations. Design/Methods This was an observational retrospective study of infants presenting with BRUE between the age of 7 days and 60 days between January 1 2010 and October 1 of 2018. Patients were selected if they matched the definition of BRUE defined by the American Academy of Pediatrics in 2016. Patient demographics and antecedents, characteristics of the events, investigations results, recurrence of BRUE, and hospitalizations until the age of 1 year were recorded. Results 103 patients presented with BRUE under the age of 2 months. Of those, 63 (61.2%) were boys. Only four (3.9%) had a recurrence of BRUE. The mean corrected age at the presentation was 20.7 days. Thirty-three (32%) infants had an overnight oximetry; of those 19 (18.4%) had an abnormal result. An abnormal overnight oximetry result was associated with a lower risk of recurrent BRUE (0%) compared to infants without an oximetry (4.3%) or with a negative result (7.1%) (p=0.6195). 68.4% of patients with an abnormal overnight oximetry had received medical treatment (caffeine, oxygen or anti-acid), which was significantly higher than those with normal overnight oximetry (14.3%) or no oximetry (9.4%) (p < 0.0001). There was an association between male sex and abnormal overnight oximetry (p=0.0137). No other investigation was able to predict a higher risk of recurrent BRUE among those evaluated. Conclusion In our cohort, boys were more frequently affected and had a higher rate of abnormal overnight oximetry. One hypothesis is that BRUE under 2 months of age might be a presentation mode for immature respiratory control and boys might be at higher risk for such events. Even though an abnormal result was present in 18.4% of the overnight oximetry, this investigation was not able to identify infants at higher risk of recurrent BRUE. This could be partly explained by the fact that a recurrent BRUE is a rare event and that a majority of patients with abnormal overnight oximetry were treated medically, which might have prevented recurrence.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».