Adverse outcomes associated with gastroesophageal reflux disease are rare following an apparent life-threatening event

J Hosp Med. Jul-Aug 2012;7(6):476-81. doi: 10.1002/jhm.1941. Epub 2012 Apr 24.


Objective: To evaluate for adverse outcomes associated with gastroesophageal reflux disease (GERD) following an apparent life-threatening event (ALTE) and potential risk factors of these outcomes.

Study design: Retrospective cohort study of well-appearing infants (<12 months) admitted for ALTE. Patients were followed for adverse outcomes associated with GERD (including aspiration pneumonia, failure-to-thrive, or anti-reflux surgery), second ALTE, or death. Risk factors evaluated included: age, prematurity, gender, previous event, diagnosis of GERD, gastrointestinal (GI) testing positive for gastroesophageal reflux, length of stay (LOS), and neurologic impairment diagnosed in follow-up.

Results: Four hundred sixty-nine patients met inclusion criteria, mean age was 45 days, 110 (22%) were premature. Patients were followed for an average of 7.8 years; 3.8% of all patients had an adverse outcome associated with GERD. The only significant risk factors were a longer LOS, and development of neurological impairment. A diagnosis of GERD and positive reflux testing during the initial hospitalization were not associated with adverse outcomes associated with GERD.

Conclusions: Adverse outcomes associated with GERD are rare following an ALTE. Patients who developed neurological impairment and a longer initial LOS were at higher risk for developing these outcomes. Positive testing for gastroesophageal reflux during hospitalization for ALTE did not predict adverse outcomes associated with GERD.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Failure to Thrive / etiology
  • Follow-Up Studies
  • Fundoplication / adverse effects
  • Fundoplication / statistics & numerical data
  • Gastroesophageal Reflux / complications*
  • Gastroesophageal Reflux / diagnosis
  • Gastroesophageal Reflux / surgery
  • Hospitals, Pediatric / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Length of Stay
  • Nervous System Diseases
  • Outcome Assessment, Health Care*
  • Patient Readmission / statistics & numerical data*
  • Pneumonia, Aspiration / etiology
  • Retrospective Studies
  • Risk Factors
  • Sex Distribution
  • Utah