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

Choi, Hee Joung; Kim, Yeo Hyang

In previous studies of ALTE prognosis after discharge, the mortality rate was 0%-0.5% during 12-60 months of follow-up (3, 9, 22, 23) . Recently, Kant et al. (24) reported a mortality after discharge of 1.1% (2 deaths/174 infants) during 34 months of follow-up, with 2 deaths occurring within 15 days of discharge. Bonkowsky et al. (22) studied the recurrence of ALTE and found that 71% of the initial patients with ALTE returned to the hospital within 1 month with a second event. This study showed the importance of close follow-up after discharge. The authors also found that 5% of patients developed adverse neurological outcomes, including chronic epilepsy and developmental delays. Nunes et al. (25) reported that among 56 patients with ALTE, 51.5% show ed normal outcome, 4 showed repeated ALTE, and none report ed deaths due to SIDS. The authors concluded that the outcome is generally related to the associated underlying disease. We found no cases of mortality after discharge, but there were 4 cases (15.4%) of recurrent ALTE after discharge occurring nearly within 2 weeks. During the median 6-month followup period, 4 patients (15.4%) showed developmental abnormalities, although we could not definitively identify the relationship between developmental delay and ALTE relapse. Our study had several limitations. The present study was a small sized retrospective study, and patients' data were collected only from a retrospective chart review. Accordingly, we could have missed some portion of ALTE patients. The number of deaths was too small to analyze any potentially significant difference of clinical course according to death.