Outcomes for infants with BRUE diagnosed with oropharyngeal dysphagia or gastroesophageal reflux disease: a multicenter study from the Pediatric Health Information System Database.

We aimed to determine the prevalence of gastroesophageal reflux disease (GERD) and oropharyngeal dysphagia as explanatory diagnoses, risk factors for acid suppression treatment, and risk factors for repeat hospital visit in infants hospitalized after brief resolved unexplained event (BRUE) using a multicenter pediatric database. We performed a multicenter retrospective database study of infants admitted with BRUE in the Pediatric Health Information System between 2016 and 2021. Data included diagnostic testing, explanatory diagnoses, treatment with acid suppression, and related repeat hospital visits within 6 months. Multivariable logistic regression models were used to determine risk factors for treatment with acid suppression and repeat hospital visit. Of 17,558 subjects admitted to 47 hospitals, 34% were given an explanatory diagnosis of GERD and 1.4% oropharyngeal dysphagia. Twelve percent were treated with acid suppression, with some centers having rates as high as 26%. Multiple factors, including most notably the GERD diagnosis, were associated with increased prescribing risk. Ten percent of subjects had repeat hospital visits. Subjects given an explanatory diagnosis of GERD (OR 1.66, 95% CI 1.48-1.86, p < 0.001) or oropharyngeal dysphagia (OR 2.13, 95% CI 1.55-2.91, p < 0.001) had increased risk for repeat hospital visit as did those treated with acid suppression. CONCLUSION: GERD as an explanatory diagnosis was associated with increased risk of repeat hospital visit, despite its conception as a benign, treatable condition. Treatment with acid suppression was common but did not prevent repeat hospitalization. Oropharyngeal dysphagia as an explanatory diagnosis was also associated with increased risk of repeat hospital visit.