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

Choi, Hee Joung; Kim, Yeo Hyang

After analyzing the relationship between the patients' clinical characteristics and significant intervention scores, we saw that patients with ALTE during sleep had significantly lower scores ( Fig. 2 , P = 0.015) compared to patients with ALTE during wakefulness. We also saw that patients with previous respiratory symptoms had significantly higher scores (Fig. 2 , 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. 3 , r = 0.330, P = 0.080). Table 4 summarizes the common causes of ALTE. The most common ALTE cause was respiratory disease, including respiratory infection in 10 patients and upper airway anomalies in 3. The next most common cause was neurologic disease such as a convulsive disorder, congenital hypoventilation syndrome, and Haddad syndrome. Three patients had confirmed bacterial meningitis and sepsis. Gastroesophageal reflux (GER)-related ALTE was diagnosed in 3 patients, prematurity-related causes in 2, previously known congenital heart disease-related ALTE in 1, and sedative medication-related ALTE in 1. Two cases of ALTE remained unexplained. The median duration of hospitalization was 8.0 days (range, 2-38 days), and 20 patients (69.0%) showed repeat ALTE in the hospital. There were 2 cases of death, resulting in an overall mortality rate of 6.9%. One death caused by group B streptococcal meningitis occurred at 25 days after admission. Both CSF and blood culture confirmed his streptococcal infection, and abnormal findings were also seen in his EEG and brain sonography. The other death with unexplained ALTE occurred at 18 days after admission. She had preterm birth and low birth weight history and diagnosed as bronchopulmonary dysplasia previously.