J Korean Med Sci.  2015 Jun;30(6):763-769. 10.3346/jkms.2015.30.6.763.

Relationship between the Clinical Characteristics and Intervention Scores of Infants with Apparent Life-threatening Events

• Choi HJ
• Kim YH

• KMID: 2160606
• DOI: http://doi.org/10.3346/jkms.2015.30.6.763

Abstract

We investigated the clinical presentations, diagnostic and therapeutic modalities, and prognosis from follow-up of infants with apparent life-threatening events (ALTE). In addition, the relationship between the clinical characteristics of patients and significant intervention scores was analyzed. We enrolled patients younger than 12 months who were diagnosed with ALTE from January 2005 to December 2012. There were 29 ALTE infants with a peak incidence of age younger than 1 month (48.3%). The most common symptoms for ALTE diagnosis were apnea (69.0%) and color change (58.6%). Eleven patients appeared normal upon arrival at hospital but 2 patients required cardiopulmonary resuscitation during the initial ALTE. The most common ALTE cause was respiratory disease, including respiratory infection and upper airway anomalies (44.8%). There were 20 cases of repeat ALTE and 2 cases of death during hospitalization. Four patients (15.4%) experienced recurrence of ALTE after discharge and 4 patients (15.4%) showed developmental abnormalities during the follow-up period. The patients with ALTE during sleep had lower significant intervention scores (P=0.015) compared to patients with ALTE during wakefulness and patients with previous respiratory symptoms had higher significant intervention scores (P=0.013) than those without previous respiratory symptoms. Although not statistically significant, there was a weak positive correlation between the patient's total ALTE criteria and total significant intervention score (Fig. 2, r=0.330, P=0.080). We recommend that all ALTE infants undergo inpatient observation and evaluations with at least 24 hr of cardiorespiratory monitoring, and should follow up at least within a month after discharge.

Keyword

Apparent Life-threatening Event; Infant; Hospitalization; Intervention

MeSH Terms

Age Distribution
Clinical Decision-Making
Critical Care/*statistics & numerical data
Critical Illness/*mortality/*therapy
Female
*Hospital Mortality
Hospitalization/*statistics & numerical data
Humans
Incidence
Infant
Infant, Newborn
Male
Republic of Korea/epidemiology
Risk Factors
Sex Distribution
Survival Rate
Treatment Outcome

Figure

• 

  Fig. 1 Age of patients. Peak incidence of age was younger than 1 month (48.3%); 69.0% of patients were younger than 2 months.

• 

  Fig. 2 Significant intervention scores according to ALTE situation and recent URI history. The patients with ALTE during sleep had significantly lower scores (P = 0.015) compared to patients with ALTE during wakefulness, and the patients with previous respiratory symptoms had significantly higher scores (P = 0.013) than those without previous respiratory symptoms.

• 

  Fig. 3 Relationship between total significant intervention scores and number of ALTE criteria. There was a positive correlation between increasing ALTE criteria and total significant intervention score (r = 0.330, P = 0.080).

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