Apparent life-threatening events in infants: a single-center experience

Abstract

Background Apparent life-threatening events (ALTEs) occur with diverse underlying medical conditions. Objective We aimed to assess the clinico-epidemiological characteristics of ALTEs in our locality in the Delta region located in Northern Egypt. Patients and methods A prospective cohort study included 53 patients younger than 1 year, who presented with ALTEs in emergency department of Mansoura University Children’s Hospital. All patients were subjected to full history taking, physical examination, and basic laboratory panel. Further investigations were individualized. All patients had 1-year follow-up for recurrence and outcome. Results The study included 53 patients, comprising 28 (52.8%) females, and the median age was 6 weeks (range, 2 days–11 months). Thirty-nine (73.6%) patients were defined as high-risk age group (below 2 months). Most of the patients had normal vital signs and stable medical condition at the time of their examination in the emergency department (40 cases, 75.5%). Recurrent ALTE was observed in 35 (66%) patients. Cardiac arrest occurred in 20.8% of patients, and eight of them died. Multivariate analysis revealed a significant effect of the cardiac arrest (odds ratio, 24; 95% confidence interval, 3.8–152.2; P=0.001) and abnormal physical examination (odds ratio, 15.5; 95% confidence interval, 1.74–138.2; P=0.014) on the number of deaths. Conclusion ALTE in our locality turned out not to be a rare condition. Its recognition and appreciation of the abnormal symptoms reported by the parents are important to promptly define any underlying etiology. Structured history and examination with tailored investigations have a high diagnostic yield.