Accident And Emergency Department Research Articles

Orthopaedic Out of Bed Project (OOBP): improving early mobilisation following femoral fracture using a therapy-led education programme

Delayed mobilisation following hip fracture surgery is detrimental to patients and health systems. Prolonged hospital stay additionally results in decreased function and increased mortality. Our hospital was underperforming against the...

Type 1 Diabetes Mellitus Clinical Profile and Follow-up: North Emirate Hospitals’ Experience

Background: Type 1 Diabetes mellitus (DM) is a chronic metabolic disorder in children and adolescents due to insulin deficiency. The disease is more common below 19 years of age with two peaks of incidence, one at 4-6 years and the other peak at early puberty (10-14 years). There is a gradual increase in the incidence of type 1 DM and a rise in incidence at 10,200 cases per year in the Middle East. Chronic type-1 diabetic patients develop microvascular and macrovascular complications. Methods: The present retrospective cross-sectional study aims to describe the experience on the clinical profile, morbidity profile, and comorbidities of Type1 DM in children below 15 years of age admitted to the SAQR and Fujairah hospitals in the Northern part of United Arab Emirates (UAE) from 1st January 2017 to 31st December 2019. The study material was the digital medical records of children below 15 years who got admitted to emergency and pediatric wards with type 1 Diabetes mellitus (T1DM) in SAQR and Fujairah hospitals. Results: Total admissions during the study period were 98. At the time of diagnosis, 12.2% of children were below five years of age, whereas 87.75% were more than five years. All 98 children were UAE nationals, of which 52% were males and 48% were females. 50% of our study population has a strong family history of either type 1 or type 2 diabetes mellitus, of which 12.2% of siblings of the study population had T1DM. The first symptoms in 58% and 57% of children were polyuria and polydipsia. Among 90 % of children under follow-up for three years, one child developed microalbuminuria, three developed systolic hypertension, and 8% were lost to follow-up. Conclusions: The present study highlights the need for future prospective studies in the UAE to know the actual burden of the disease with an emphasis on early screening.

From research to daily clinical practice: implementation of orthogeriatric co-management in the trauma ward.

Evidence strongly suggests that orthogeriatric co-management improves patient outcomes in frail older patients with a fracture, but evidence regarding how to implement this model of care in daily clinical practice is scarce. In this paper, we first describe the implementation process and selection of implementation strategies for an orthogeriatric co-management program in the traumatology ward of the University Hospitals Leuven in Belgium. Second, we report the results of a multi-method feasibility study. This study (1) measures the fidelity towards the program's core components, (2) quantifies the perceived feasibility and acceptability by the healthcare professionals, and (3) defines implementation determinants. Implementation strategies were operationalized based on the Expert Recommendations for Implementing Change (ERIC) guidelines. In the feasibility study, fidelity towards the core components of the program was measured in a group of 15 patients aged 75 years and over by using electronic health records. Feasibility and acceptability as perceived by the involved healthcare professionals was measured using a 15-question survey with a 5-point Likert scale. Implementation determinants were mapped thematically based on seven focus group discussions and two semi-structured interviews by focusing on the healthcare professionals' experiences. We observed low fidelity towards completion of a screening questionnaire to map the premorbid situation (13%), but high fidelity towards the other program core components: multidimensional evaluation (100%), development of an individual care plan (100%), and systematic follow-up (80%). Of the 50 survey respondents, 94% accepted the program and 62% perceived it as feasible. Important implementation determinants were feasibility, awareness and familiarity, and improved communication between healthcare professionals that positively influenced program adherence. Fidelity, acceptability, and feasibility of an orthogeriatric co-management program were high as a result of an iterative process of selecting implementation strategies with intensive stakeholder involvement from the beginning. [https://www.isrctn.com/ISRCTN20491828], International Standard Randomised Controlled Trial Number (ISRCTN) Registry: [ISRCTN20491828]. Registered on October 11, 2021.

The outcomes of cardiopulmonary resuscitation and their predictors during the coronavirus 2019 pandemic in Iran

BackgroundCoronavirus disease 2019 (COVID-19) can negatively affect different healthcare-related outcomes. Nonetheless, there is limited information about its effects on different healthcare-related outcomes. This study aimed at evaluating the outcomes of cardiopulmonary resuscitation (CPR) and their predictors during the COVID-19 pandemic in Iran.MethodsThis cross-sectional study was conducted on 1253 patients who had undergone CPR in the emergency wards of teaching hospitals in the west of Iran from the beginning of the first wave to the end of the third epidemic wave of COVID-19 in Iran, between February 20, 2020, and January 20, 2021. Data were collected using the National CPR Documentation Forms developed based on the Utstein Style and routinely used for all patients with cardiac arrest (CA). The SPSS (v. 20.0) program was used to analyze the data through the Chi-square, Fisher’s exact, and Mann-Whitney U tests and logistic regression analysis.ResultsParticipants’ age mean was 64.62 ± 17.54 years. Age mean among participants with COVID-19 was eight years more than other participants. Most participants were male (64.09%) and had at least one underlying disease (64.99%). The total rates of the return of spontaneous circulation (ROSC) and CPR–discharge survival were respectively 15.3% and 3.8% among all participants, 20.25% and 5.17% among participants without COVID-19, and 8.96% and 2.04% among participants with COVID-19. The significant predictors of ROSC were age, affliction by COVID-19, affliction by underlying diseases, baseline rhythm, delay in epinephrine administration, and epinephrine administration time interval, while the significant predictors of CPR–discharge survival were age and baseline rhythm.ConclusionsThe total rates of ROSC and CPR–discharge survival were respectively 15.3% and 3.8% among all participants. The rates of ROSC and CPR to discharge survival among patients without COVID-19 are respectively 2.26 and 2.53 times more than the rates among patients with COVID-19.

Frequency of Needle Wound Injury (Needle-stick) and Its Related Factors in Nursing Staff in Sirjan in 2020

Background: Nurses are exposed to blood-borne infections such as hepatitis B (HB), hepatitis C (HC), and human immunodeficiency virus (HIV) through needle-stick injuries (NSIs). Objectives: This study aimed to determine the prevalence of needle sticks and their related factors among nurses in the hospitals of Sirjan. Methods: In this cross-sectional study, 312 nurses were enrolled by census. Data were collected using demographic characteristics and a needle-stick information questionnaire. Descriptive and analytical tests (chi-square or Fisher’s exact test and logistic regression model) were used to analyze data. Results: Out of 312 nurses participating in the study, 189 (60.6%) had experienced NSIs during the last year. The most common objects for NSIs were syringes and needles (35.4%), and the most common cause of NSIs was recapping (45.4%). In this study, 82% of needle-stick nurses were forced to work overtime. Ages of 20 - 29 years (odds ratio (OR) = 3.94, 95%CI: 1.12 - 13.84; P = 0.032), work experience between 5 - 10 years (OR = 2.50, CI: 1.12 - 5.57; P = 0.02), HB vaccination (OR = 0.26, CI: 0.07 - 0.98; P = 0.04) were significantly associated with rates of needle-sticks. Conclusions: Due to the high frequency of NSIs among the nursing staff and to reduce these injuries, using safety devices, especially in the emergency ward, providing a calm and stress-free environment for staff, reducing the number of night shifts and workload, teaching safety principles and standards to young nurses and supporting nurses who experience NSIs were advised.

A case for routine microbial diagnostics: Results from antimicrobial susceptibility testing in post-traumatic wound infections at a Ugandan tertiary care hospital.

The global spread of antimicrobial resistance (AMR) poses an increasing challenge for clinicians in Uganda, where microbiological diagnostics are not routinely available or accessible. The aim of this study was to determine pathogen prevalence and antibiotic resistance patterns in patients with wound infections following trauma at a national referral hospital in Kampala, Uganda. In addition, the suitability of currently used empirical treatment options in this setting was evaluated. This prospective, observational study analysed antimicrobial prescriptions, culture results and antimicrobial sensitivity testing (AST) of wound swabs and blood samples from patients with clinical signs of wound infections on the trauma ward. A total of 124 patients (n = 99, 79.8% male) with a median age of 30 years (IQR 23-39) were enrolled between October 2021 and January 2022. Wound infections were classified as nosocomial in 69% of the cases. Pathogens were isolated from 122 wound swabs, yielding 238 bacterial isolates. The most prevalent pathogens were gram-negative bacteria including Escherichia coli (n = 48, 20.2%) and Acinetobacter spp. (n = 43, 18.1%). Empiric treatment consisted of ceftriaxone and gentamicin which was administered to 67.2% (n = 78) and 62.1% (n = 72) of patients, respectively. High rates of antimicrobial resistance could be demonstrated across gram-negative and gram-positive species towards the most common empiric antibiotics. Following the AST results, over 95% (n = 111) of patients required a change of treatment. Our findings demonstrate that current empiric treatment for wound infections is missing its target in hospitalized patients in Kampala. To address the growing problem of AMR in Uganda, there is a pressing need to enhance diagnostic capacity and implement structured antimicrobial stewardship programs.

The PENINGKATAN KAPASITAS PELAYANAN PENANGANAN STROKE ISKEMIK AKUT MELALUI PELATIHAN CODE STROKE DI RS UNIVERSITAS MATARAM

Stroke is the leading cause of death and disability in the world and Indonesia. The standard therapy for acute ischemic stroke is alteplase but only 10-20% of patients receive this standard therapy. Code stroke is quick response for management acute stroke to get alteplase. The success for code stroke requires good communication and cooperation of code stroke team. This training aims to provide code stroke training needed to increase the capacity of stroke services at Mataram University Hospital. The method of training include lecture, patient simulation, video on the code stroke and also preparation of the thrombolysis also discussion and the target of this training are doctors and staffs in the emergency wards, radiology, laboratorium, pharmacy, ICU and inpatient ward. Evaluation of participants' understanding through pre and post tests was assessed with the Kahoot application. Evaluation of the training was also assessed using the Google form. A total of 25 health workers participated in this activity. The mean pre and post test were 34,38% and 68,42% (an increase of 34%). Participants' satisfaction with the activity was good, namely 4.13 (from a Likert scale of 0 – 5). The aspect of material provided in this training had the highest satisfaction score. This education should be given periodically to all health workers to increase the capacity of stroke services.

Hospital mortality rate and predictors in acute pancreatitis in Poland: A single-center experience

BackgroundDespite advances in medicine, acute pancreatitis remains a disorder that is associated with a high mortality rate. The objective of this study was to analyze in-hospital mortality in patients hospitalized with acute pancreatitis. MethodsA prospective analysis of patients hospitalized with acute pancreatitis in a single surgical center was performed. Etiological factors, concomitant diseases, age, and intensive care unit treatment status were assessed to determine their impact on the cause and time of patient death. In addition, conventional laboratory tests performed in the emergency ward were evaluated for their potential as predictors of mortality. ResultsThe study included 476 (n) patients hospitalized with acute pancreatitis in a single surgical center. The presentations included mild disease in 261 (54.8%) patients, moderate disease in 132 (27.7%) patients, and severe disease in 83 (17.5%) patients. The overall mortality rate was 7.14% (n = 34), including 41% in the severe disease group. The mean and median hospitalization times for these patients were 13.9 and 7 days, respectively. Respiratory failure is the main cause of patient death. ConclusionsAcute pancreatitis remains one of the most common gastroenterological diseases that may lead to death. Acute pancreatitis-related respiratory failure is the most common cause of death among patients with alcohol etiology of the disease. Moreover, the mortality rate was higher among older patients. Therefore, actions should be taken to discover prognostic factors of the severe form and initiate appropriate treatment.

Contribution of contrast-enhanced ultrasound in the diagnosis of adnexal torsion (AGATA): protocol for a prospective comparative study

IntroductionAdnexal torsion is a surgical emergency and its prognosis depends on the time elapsed prior to treatment. The diagnosis relies on pelvic ultrasound in which sensitivity remains low and may...

Resistance pattern of isolated microorganisms from 783 clinical specimen cultures in patients admitted to Yasuj Educational Hospitals, Iran

BackgroundInfectious diseases are still one of the leading causes of morbidity and mortality in resource-limited settings. Serious infection caused mostly by gram-negative pathogens causes significant morbidity. According to the Centers for Disease Control and Prevention, antimicrobial resistance kills over 700,000 people worldwide. Antibiotic resistance is on the rise, and as a consequence, serious public health issues are arising. The present study investigated isolated clinical samples from Yasuj teaching hospitals to determine the antimicrobial resistance profile to various antibiotics.Materials and methodsMicrobial isolates regarding cultures from urine, blood, wound, abdominal tap, throat, stool, cerebrospinal fluid, endotracheal tube, sputum, skin lesion, nasal, and mouth secretion were collected from patients admitted to hospitals affiliated with Yasuj teaching hospitals. Antibiotic susceptibility profiles were determined by using the Kirby-Bauer disc diffusion method. Data were tabulated and analyzed with SPSS version 26.0.ResultsA total of 783 samples were evaluated in our study, with an average of 30.6 years and 54.5% female patients. Most of the bacterial isolates were gram-negative (64.2%). The majority of cultures were Escherichia coli (49.9%), mainly among urine samples (64.2%). The frequency distribution of norfloxacin antibiotic resistance was more common in internal medicine (66.7%), infectious (63.6%), and emergency wards (58.8%). The frequency distribution of penicillin antibiotic resistance was statistically significant in different wards. All cases of oxacillin were resistant.ConclusionOur data showed a high level of antibiotic resistance among bacterial isolates in our center. Considering widespread empirical antibiotic therapy in Iran, the rate of increasing resistance to common antibiotics prescribed for ambulatory and hospitalized patients is concerning. We recommend providing more strict guidelines and policies to control the overuse and overprescription of antimicrobials by health policy-making organizations.

Impact of COVID-19 pandemic on health care workers (HCWs) in Sindh Province of Pakistan

BackgroundIn Pakistan, the COVID-19 outbreak posed a significant challenge for healthcare workers in the country’s public hospitals. The HCWs faced several problems in terms of the COVID-19 pandemic. Therefore this study investigated how the COVID-19 pandemic has affected the medical staff at the public hospital in Sindh Province, Pakistan.MethodsIn this study, a qualitative exploratory design was used. Semi-Structure interviews (SSI) were conducted by using an open-indeed questionnaire (OIQ) for data collection. An inductive approach was used for theoretical data analysis. A total of 320 HCWs participated to complete the criteria of the study from 10 different public hospitals.ResultsThe study result showed the Sindh public hospital’s insufficient infrastructure, lack of health protective equipment, shortages of isolation rooms and beds, and emergencies during the COVID-19 pandemic caused HCWs to experience physical and psychological weariness, sleep disturbance, mental stress, and fear of infection.ConclusionThe study concluded that public hospitals’ insufficient infrastructure, furniture, emergency wards, and safety equipment during the COVID-19 pandemic significantly damaged HCWs’ physical and psychological health, generating fear of infection and sleep disturbance. Additionally, Sindh healthcare workers’ fear of illness and isolation may impair family connections.

Notice of Retraction: The Effect of Aromatherapy with the Essential Oil of Orange on Pain and Vital Signs of Patients with Fractured Limbs Admitted to the Emergency Ward: A Randomized Clinical Trial.

[This retracts the article DOI: 10.4103/IJPC.IJPC_37_17.][This retracts the article DOI: 10.15452/CEJNM.2017.08.0024.].

Retracted: Study on the Relationship between AAD and Clinical Features in Emergency Ward Patients and the Application Effect of Probiotics.

[This retracts the article DOI: 10.1155/2022/6164843.].

Correlates of patient satisfaction with pain management at the Ho Teaching Hospital in Ghana: A cross-sectional study

Pain is a symptom that many people who visit the hospital with various illnesses experience. Inadequate pain management has been regularly shown to have a negative impact on patients' health and reduce patient satisfaction. Patients' satisfaction with pain management is therefore important. The aim of this study was therefore to assess patients’ satisfaction and experience with pain management at the Ho Teaching Hospital, Volta Region, Ghana. The study was a prospective cross-sectional investigation and was carried out among 196 adult patients (older than 18 years) at the emergency, medical, and surgical wards. Data was collected using the 2010 version of the patient outcome and satisfaction survey questionnaire developed by the American Pain Society. Descriptive and inferential statistical analysis were employed in analysing the data obtained from the respondents. p-value less than 0.05 was considered as statistically significant.The results revealed that 96% of the respondents were satisfied with their pain management. Expectations for pain treatment (r = 0.221, p-value=0.002), percentage of pain relief in first 48 h (r = 0.439, p-value<0.001) and how helpful the information was (r = 0.158, p-value=0.027) were positively correlated with satisfaction with pain treatment. In addition, the median satisfaction with pain treatment was higher for those with knowledge on pain medication (p-value=0.043), and patients who were allowed to participate in decision-making indicated a higher level of satisfaction.The majority of patients (95% with acute pain and 100% with chronic pain) were satisfied with their pain management. Aside the effective use of analgesics, it was found that patient satisfaction can also be enhanced by good patient-provider relationships, providing patients with helpful information about their pain treatment, and allowing patients to participate in decisions about their pain management. This research is the first to provide such information for pain management in the Volta Region of Ghana.

Effect of COVID-19 Pandemic on Emergency Department Admissions and Outcome.

Emergency Department admissions have changed significantly during the COVID-19 pandemic. Understanding this variation may play a crucial role in rearranging hospital resources for better outcome. In this study, we aimed to assess the impact of COVID-19 pandemic on emergency department admission and outcome. This is a cross-sectional retrospective study conducted at Bharatpur Hospital, Nepal comparing pre- pandemic data of the 4 months (March 24 to July 21, 2019) with the initial 4 months of the pandemic (March 24 to July 21, 2020). Admission in emergency ward decreased during covid period among female admission (47%vs43%), age-group(0-14)(18%vs12%), Dalit(17%vs11%) p<0.0001.Diagnosis increased during covid for acute abdomen(11%vs13%), animal and insect bite(10%vs13%), psychiatric illness(2%vs6%),poisoning and drug over dose(0.9%vs2.6%)(p<0.0001).The odds for referral(cOR 3.62,95% CI:2.70-4.84), Left against medical advice(cOR 6.03,95% CI:.06-8.94) and death(cOR 3.28,95% CI:1.64-6.68) increased during the covid respectively. There was decrease in rates of emergency department utilization during the Covid-19 pandemic. Admissions due to trauma, gastrointestinal, respiratory, neurological, musculoskeletal and coronary artery disease showed a decline whereas psychiatric disorders, diabetes and hypertension, animal and insect bites cases increased. Overall, mortality rate was increased.

Evaluation of management of Cesarean Scar Pregnancy (CSP).

Objective: To evaluate our experience in treatment of Caesarean Scar Pregnancy (CSP). Study Design: Cross Sectional Descriptive study. Setting: Department of Gynecology and Obstetrics, Independent Medical College Faisalabad. Period: Jan 2016 to Jan 2021. Material &amp; Methods: The data for this study retrospectively obtained from outpatient department, emergency ward and labor ward registers. Data was analyzed by simple descriptive statics. Diagnosis of CSP was made by using transvaginal ultrasound and color flow Doppler ultrasound. Treatment offered was either medical management as systemic methotrexate or surgical as D&amp;C or laparotomy. The aim was to do conservative treatment for fertility sparing. Patient age, gestational age at time of presentation, number of previous Cesarean Section and success of overall management strategy was analyzed. Results: In this study we had 12 patients diagnosed to have CSP with at least one scar on uterus of previous caesarean section. The mean age of patients was 32.5± 2 years and the gestational age range was from 5 weeks and 3 days to 10 weeks and 1 day. The diagnosis was done by using transvaginal ultrasound and color flow Doppler ultrasound. Which showed high velocity and low impedance flow in sub trophoblastic area. Out of 12 patient’s 58.33 percent were treated with systemic methotrexate and had successful outcome. These were followed by B-hCG levels till non pregnant serum level of B-hCG of &lt;5.1IU was achieved. 16.66 percent patients underwent D&amp;C, but due to hemorrhage they were treated with laparotomy as supplementary procedure. 41.55 percent Patients were treated by laparotomy as their primary management with aim of fertility sparing surgery. The laparotomy was found to be successful treatment in all the patients who underwent surgical management as their primary treatment. Conclusion: Prompt diagnosis has pivotal role in reducing morbidity and mortality associated with CSP. Medical management is found to be successful at early gestational age. Fertility sparing surgery is better option as gestation advances more than 8 weeks to avoid undesirable outcome like hemorrhage and hysterectomy.

Hypertensive Retinopathy among Patients with Hypertension Attending the Department of Ophthalmology in a Tertiary Care Centre: A Descriptive Cross-sectional Study

Introduction: Hypertension is one of the major cardiovascular diseases leading to disability or death. Persistently elevated blood pressure leads to retinal vascular changes, also known as hypertensive retinopathy. The aim of this study was to find out the prevalence of hypertensive retinopathy among patients with hypertension attending the Department of Ophthalmology in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among hypertensives patients presenting to the Department of Ophthalmology in a tertiary care centre from 1 June 2022 to 1 February 2023 after receiving ethical approval from the Institutional Review Committee (Reference number: CMC-IRC 078/079-228). Those patients who did not provide informed consent and patients with chronic debilitating systemic conditions, patients encountered in emergency wards, and hypertensive patients below 15 years of age and above 75 years of age were excluded from the study. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 336 study participants, hypertensive retinopathy was found in 66 (19.64%) (15.39-23.89, 95% Confidence Interval) study subjects in at least one eye. Conclusions: The prevalence of hypertensive retinopathy was lower in our study when compared to other studies.

Identifying Quality Indicators for the Care of Hospitalized Injured Older Adults: A Scoping Review of the Literature.

Older adults represent more than 50% of trauma admissions in many high-income countries. Furthermore, they are at increased risk for complications, resulting in worse health outcomes than younger adults and a significant health care utilization burden. Quality indicators (QIs) are used to assess the quality of care in trauma systems, but few QIs reflect responses to older patients' specific needs. We aimed to (1) identify QIs used to assess acute hospital care for injured older patients, (2) assess support for identified QIs and, (3) identify gaps in existing QIs. Scoping review of the scientific and gray literature. Selection and data extraction were performed by 2 independent reviewers. The level of support was assessed by the number of sources reporting QIs and whether they were developed according to scientific evidence, expert consensus, and patients' perspectives. Of 10,855 identified studies, 167 were eligible. Among 257 different QIs identified, 52% were hip fracture specific. Gaps were identified for head injuries, rib, and pelvic ring fractures. Although 61% of QIs assessed care processes, 21% and 18% focused on structures and outcomes, respectively. Although most QIs were based on literature reviews and/or expert consensus, patients' perspective was rarely accounted for. The 15 QIs with the highest level of support included minimum time between emergency department arrival and ward admission, minimum time to surgery for fractures, assessment by a geriatrician, orthogeriatric review for hip fracture patients, delirium screening, prompt and appropriate analgesia, early mobilizations, and physiotherapy. Multiple QIs were identified, but their level of support was limited, and important gaps were identified. Future work should focus on achieving consensus for a set of QIs to assess the quality of trauma care to older adults. Such QIs could be used for quality improvement and ultimately improve outcomes for injured older adults.

Relations between PTSD symptom clusters and pain in three trauma-exposed samples with pain.

Little is known about how the individual PTSD symptom clusters relate to intensity and interference of pain and whether these relationships differ across clinical groups. The present study examines relations between PTSD symptom clusters and pain in three trauma-exposed, unique clinical groups: 1) adults seeking treatment for chronic pain with current symptoms of PTSD, 2) trauma affected refugees seeking treatment for PTSD and chronic pain; and 3) individuals identified at admission to the emergency ward after whiplash injury. Network analysis was used to assess unique relations between pain intensity, pain interference, re-experiencing, avoidance, numbing, hyperarousal, depression, and anxiety separately in each sample. Links between PTSD clusters and pain were then compared within and between samples. No within-group differences were identified for the links between pain and any of PTSD clusters in the chronic pain and refugee groups. In the whiplash group, hyperarousal was more strongly related to pain than re-experiencing, avoidance, and numbing. Between group comparisons revealed a more pronounced relationship between hyperarousal and pain in the whiplash group, with no between-group differences between the chronic pain and refugee groups. The findings suggest that when depression and anxiety are accounted for, few unique associations are found between pain and the PTSD symptom clusters in trauma-exposed samples with pain, with the exception of a link between pain and hyperarousal in individuals with whiplash-related PTSD symptoms.

Brief resolved unexplained event: Severity-associated factors at admission in the pediatric emergency ward

ObjectiveA brief resolved unexplained event (BRUE) is a recent clinical entity that has now replaced the term “infant discomfort”. Despite the availability of recent recommendations, identification of patients requiring further examination remains difficult. MethodWe aimed to identify factors associated with severe pathology and/or recurrence by studying the medical files of 767 patients admitted to the pediatric emergency department of a French university hospital for a BRUE. ResultsOverall, 255 files were studied; 45 patients had a recurrence and 23 patients had a severe diagnosis. The most frequently found etiology was gastroesophageal reflux in the benign diagnosis group and apnea or central hypoventilation in the severe diagnosis group. Prematurity (p = 0.032) and time since last meal >1 h (p = 0.019) were the main factors associated with severe disease. Most of the routine examination results remained non-contributive to the etiology. ConclusionAs prematurity is a factor associated with severe diagnosis, special attention should be given to this population, without subjecting them to multiple tests, since the main complication was found to be apnea or central hypoventilation. Prospective research is needed to establish the usefulness and prioritization of diagnostic tests for infants who are at “high risk” of experiencing a BRUE.