Factors associated with infant death after apparent life-threatening event (ALTE)

Objective: to detect factors associated with greater risk of death in infants after an apparent life-threatening event (alte). methods: this cross-sectional,retrospective,descriptive and analytic study evaluated infants younger than 12 months who had a sudden event of cyanosis,pallor,hypotonia or apnea and were seen in the emergency department of a tertiary university hospital. forward stepwise logistic regression (wald) was used to calculate and adjust odds ratios to evaluate associations. results: mean age of the 145 patients included in the study was 105 days (median = 65 days). eleven (7.6%) died,and their mean age was 189 days (median = 218 days). mean age of survivors was 98 days (median = 62 days) (p = 0.003). activity before the event,prematurity and number of events were not associated with death. a significant association was found with pallor. of the 11 infants,3 had spontaneous resolution of alte,whereas 8 patients [27.6%; p < 0.001; or = 14.3 (95%ci 3.51-58.3)] did not. the associations with respiratory or cardiovascular disease were also significant. in multivariate analysis,immediate spontaneous resolution [p = 0.015; or = 6.06 (95%ci 1.02-35.94)] and diagnosis of cardiovascular disease [p = 0.047; or = 164.27 (95%ci 7.34-3.673.78)] remained statistically significant. conclusion: infants who experienced an alte had a higher risk of subsequent death when their age was greater than 6 months and the event had a long duration,particularly when alte was associated with cardiovascular disease. copyright © 2010 by sociedade brasileira de pediatria.