Abstract
The retrospective study was planned to assess the outcome of extensive investigations done for infants admitted with apparent life-threatening event (ALTE), and comprised chart review of 275 infants admitted to King Abdul-Aziz Medical City (KAMC), Riyadh, Saudi Arabia, between 2012 and 2015. The outcome of each investigation was compared in terms of whether the test was performed or not performed, and, if performed, whether the test report was normal or abnormal. Also, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) was assessed for each test. All culture tests, including those of blood, urine and cerebrospinal fluid (CSF), were of little help in contributing to the final diagnosis. Nasopharyngeal aspiration (NPA), chest X-ray and upper gastrointestinal (GI) study were more relevant in terms of finding an underlying cause for ALTE (p=0.01, p=0.04 and p<0.001 respectively). Of the total, 87(32%) subjects did not have a final diagnosis and were considered normal. Gastro-oesophageal reflux 59(22%) and bronchiolitis 58(21%) were the most common diagnoses; both can be diagnosed clinically without any invasive investigations.