BRUE 2.0 Criteria for Infants

Brief Resolved Unexplained Events 2.0 (BRUE 2.0)

Estimates the risk of a serious underlying diagnosis and a recurrent event in eligible infants after a brief resolved unexplained event.

Use only in infants younger than 1 year who are back to their usual baseline at evaluation. Do not use this tool for a symptomatic or ill-appearing infant, or when a cause for the event is identified after history and examination.

1. BRUE 2.0 entry criteria

Infant age (days)

Must be 0–364 days (younger than 1 year).

Asymptomatic and at usual baseline at evaluation?

For example, no fever, respiratory distress, or ongoing symptoms that suggest another diagnosis.

No explanation for the event after history and physical examination?

Examples of explanations may include feeding difficulties, gastroesophageal reflux, or another identified condition.

Sudden, brief, and now resolved episode included at least one qualifying feature

Select every feature observed during the event.

Cyanosis or pallor Absent, decreased, or irregular breathing Marked change in tone (hypertonia or hypotonia) Altered level of responsiveness

2. BRUE 2.0 prediction variables

History of a similar event before this presentation?

History of multiple events or an event cluster before this presentation?

Abnormal medical history?

Examples include prior NICU admission, hospitalization, congenital heart disease, infection requiring antibiotics, tube feeding, or failure to thrive.

Prematurity as defined by the model?

Gestational age <32 weeks, or 32–38 weeks with corrected age <45 weeks.

Clinical note

The model provides estimated probabilities to support clinical assessment and shared decision-making. It does not establish a diagnosis, replace history and examination, or define a universal threshold for testing, admission, or discharge.

Show calculation method

Serious underlying diagnosis: logistic(−2.9 − 0.0046 × age in days + 1.22 × similar-event history + 0.35 × abnormal medical history).

Recurrent event: logistic(−2.82 + 0.65 × similar-event history + 0.98 × multiple events/clusters + 0.28 × prematurity + 0.36 × cyanosis/pallor + 0.16 × abnormal breathing + 0.23 × marked tone change).

References: Nama N, et al. Hospital Pediatrics. 2022;12:772–780. Nama N, et al. JAMA Pediatrics. 2025;179:188–196.

1. BRUE 2.0 entry criteria

2. BRUE 2.0 prediction variables

Clinical note

Related Posts

Leave a Comment Cancel Reply