Global research trends of BRUE (brief resolved unexplained event) or formerly ALTE (apparent life-threatening event): A comprehensive visualization and bibliometric analysis from 1988 to 2024

Abstract

Objective

This study aimed to conduct a comprehensive bibliometric analysis of the literature on Brief Resolved Unexplained Event (BRUE) and its predecessor, Apparent Life-Threatening Event (ALTE), from 1988 to 2024, in order to identify research trends, collaborative networks, and areas of focus in this field.

Methods

We analyzed articles indexed in Scopus and Web of Science using various bibliometric indicators. The visualization of bibliometric networks was performed using VOSviewer and bibliometrix. Publication trends, citation analysis, co-authorship networks, and keyword co-occurrence were examined.

Results

A total of 270 articles were analyzed, of which 85.56 % were research articles and 14.44 % were review articles. The number of publications showed a significant increase over time (r = 0.73, p < 0.001). The United States emerged as the leading contributor with strong international collaborations. The most prolific journals were Pediatrics, Pediatric Emergency Care, and Journal of Pediatrics. Keyword analysis revealed a shift from terms associated with life-threatening events (e.g., SIDS, sleep apnea syndrome) to more specific terminology (BRUE) and methodological keywords over time. However, the 2016 redefinition of ALTE to BRUE did not result in a corresponding increase in publications.

Conclusion

This bibliometric analysis provides valuable insights into the evolution and current state of BRUE/ALTE research. The findings highlight the field's progression toward more precise, evidence-based approaches. The identified research trends and gaps, particularly the limited studies from developing countries, offer direction for future research. These results can inform clinical practice, guide research priorities, and support the development of standardized guidelines for BRUE/ALTE management.