• J Sánchez Etxaniz, M Santiago Burruchaga, A González Hermosa, R Rodríguez Serrano, E Astobiza Beobide, and M I Vega Martín.
• Servicio de Urgencias de Pediatría, Hospital de Cruces, Barakaldo, Bizkaia, España. jesus_sanchez_etxaniz@hotmail.com
• An Pediatr (Barc). 2009 Nov 1;71(5):412-8.

IntroductionTo report our experience with a guideline approach for the assessment of apparent life-threatening events (ALTE) in our pediatric emergency departments (PED), to know their incidence, epidemiological characteristics and the yield of laboratory investigations (LI).Patients And MethodsProspective, case-control study of a guideline approach for infants under age 12 months who suffered an ALTE between 01/06/06 and 31/05/07 and were attended at our PEDs. We ordered LI as a function of the clinical history. All the cases were admitted for a minimum of 12h. We conducted a telephone interview at 12 months.ResultsFifty ALTE were included, corresponding to an incidence of 5 per thousand live births. The median age was 8.46+/-8.7 weeks. Compared to controls they had significantly more primogenits and previous behavioral abnormalities. Only 13 presented significant abnormalities at examination, and 6 had recurrent ALTE at the PED. LI were abnormal in 41 (82%), but only in 8 cases did they contribute to a secondary diagnosis. There were 29 idiopathic ALTE (58%). Twenty one (42%) had associated conditions, who had smoked significantly more during pregnancy, age older than 12 weeks and abnormalities at examination. Four had recurrence of the episodes: one suffered a sudden infant death syndrome (SIDS). At 12 months the cases had a significantly higher incidence of recurrent vomiting, breath holding spells and weight-psychomotor retardation.ConclusionsThe ALTE incidence was 5 per thousand live births. Primogenits and/or behavioral abnormalities were most frequent during the first weeks after birth and/or thereafter at 12 months of age. A total of 42% had a related diagnosis: associated with age older than 12 weeks, maternal smoking habits and abnormalities at examination. There was one case of SIDS. Laboratory investigations had a low yield.

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