cliot (version 1.0.0)

brue_2_0_criteria: Brief Resolved Unexplained Events 2.0 (BRUE 2.0) Criteria

Description

Applies the BRUE 2.0 criteria (based on the 2016 AAP Guidelines and subsequent validation) to risk-stratify infants presenting with a Brief Resolved Unexplained Event. The tool identifies "Lower-Risk" infants who require minimal workup versus "Higher-Risk" infants who may benefit from further observation or diagnostic testing. A BRUE is defined as a sudden, brief, resolved episode of cyanosis/pallor, absent/irregular breathing, marked tone change, or altered responsiveness in an infant < 1 year, with no explanation after history and physical exam.

Usage

brue_2_0_criteria(age_days, gestational_age_weeks, duration_less_than_1_min,
                  cpr_performed, recurring_event, concerning_history,
                  concerning_exam)

Value

A list containing:

Classification

"Lower-Risk BRUE", "Higher-Risk BRUE", or "Not BRUE".

Management_Guidance

Clinical recommendations derived from AAP 2016 guidelines.

Risk_Factors_Present

A list of specific criteria that placed the patient in the Higher-Risk category.

Arguments

age_days

Numeric. Chronological age of the infant in days.

gestational_age_weeks

Numeric. Gestational age at birth in weeks.

duration_less_than_1_min

Numeric (0 or 1). Was the duration of the event < 1 minute? (1 = Yes).

cpr_performed

Numeric (0 or 1). Was CPR performed by a trained medical provider? (1 = Yes).

recurring_event

Numeric (0 or 1). Was this a recurring event (not the first episode) or part of a cluster? (1 = Yes).

concerning_history

Numeric (0 or 1). Are there concerning features in the history (e.g., family history of sudden death, social concerns)? (1 = Yes).

concerning_exam

Numeric (0 or 1). Are there concerning findings on physical examination (e.g., injury, growth failure)? (1 = Yes).

References

Tieder JS, Bonkowsky JL, Etzel RA, et al. Clinical Practice Guideline: Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants. Pediatrics. 2016;138(1):e20160590. doi:10.1542/peds.2016-0590

Examples

# Example 1: Lower-Risk BRUE
# 4-month-old (120d), term (40w), brief event, no CPR, first time, normal H&P
brue_2_0_criteria(120, 40, 1, 0, 0, 0, 0)

# Example 2: Higher-Risk BRUE (Age)
# 45-day-old, otherwise low risk
brue_2_0_criteria(45, 40, 1, 0, 0, 0, 0)

# Example 3: Higher-Risk BRUE (Duration & Recurrence)
# 3-month-old, event > 1 min, recurring
brue_2_0_criteria(90, 39, 0, 0, 1, 0, 0)