A comprehensive scoring system for the better prediction of bowel resection in pediatric intussusception

作者全名：Xia, Bingshan; Chen, Guoqiang; Liu, Qianyang; Yan, Chengwei; Lu, Peng; Guo, Chunbao

作者地址：[Xia, Bingshan; Chen, Guoqiang; Liu, Qianyang; Lu, Peng; Guo, Chunbao] Chongqing Med Univ, Womens & Childrens Hosp, Dept Pediat, 120 Longshan Rd, Chongqing 401147, Peoples R China; [Xia, Bingshan] Hechuan Maternal & Child Hlth Hosp, Dept Pediat, Chongqing, Peoples R China; [Yan, Chengwei] Chongqing Univ Three Gorges Hosp, Dept Pediat Gen Surg, Chongqing, Peoples R China; [Xia, Bingshan; Chen, Guoqiang; Liu, Qianyang; Lu, Peng; Guo, Chunbao] Chongqing Hlth Ctr Women & Children, Dept Pediat, Chongqing, Peoples R China; [Lu, Peng; Guo, Chunbao] Chongqing Med Univ, Chongqing Maternal & Child Hlth Hosp, Dept Pediat Gen Surg, Chongqing, Peoples R China

通信作者：Lu, P; Guo, CB (通讯作者)，Chongqing Med Univ, Womens & Childrens Hosp, Dept Pediat, 120 Longshan Rd, Chongqing 401147, Peoples R China.; Lu, P; Guo, CB (通讯作者)，Chongqing Hlth Ctr Women & Children, Dept Pediat, Chongqing, Peoples R China.; Lu, P; Guo, CB (通讯作者)，Chongqing Med Univ, Chongqing Maternal & Child Hlth Hosp, Dept Pediat Gen Surg, Chongqing, Peoples R China.

来源：BMC GASTROENTEROLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001229450900002

JCR分区：Q2

影响因子：2.5

年份：2024

卷号：24

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Intussusception; Scoring system; Bowel resection

摘要：Background Intussusception presents a significant emergency that often necessitates bowel resection, leading to severe complications and management challenges. This study aims to investigate and establish a scoring system to enhance the prediction of bowel resection necessity in pediatric intussusception patients. Methods This retrospective study analyzed 660 hospitalized patients with intussusception who underwent surgical management at a pediatric hospital in Southwest China from April 2008 to December 2020. The necessity of bowel resection was assessed and categorized in this cohort. Variables associated with bowel resection were examined using univariate and multivariate logistic regression analyses. Based on these analyses, a scoring system was developed, grounded on the summation of the coefficients (beta). Results Among the 660 patients meeting the inclusion criteria, 218 required bowel resection during surgery. Bowel resection occurrence was linked to an extended duration of symptoms (Odds Ratio [OR] = 2.14; 95% Confidence Interval [CI], 1.03-5.23; P = 0.0015), the presence of gross bloody stool (OR = 8.98; 95% CI, 1.76-48.75, P < 0.001), elevated C-reactive protein levels (OR = 4.79; 95% CI, 1.12-28.31, P = 0.0072), lactate clearance rate (LCR) (OR = 17.25; 95% CI, 2.36-80.35; P < 0.001), and the intussusception location (OR = 12.65; 95% CI, 1.46-62.67, P < 0.001), as determined by multivariate logistic regression analysis. A scoring system (totaling 14.02 points) was developed from the cumulative beta coefficients, with a threshold of 5.22 effectively differentiating infants requiring surgical intervention from others with necrotizing enterocolitis (NEC), exhibiting a sensitivity of 78.3% and a specificity of 71.9%. Conclusions This study successfully identified multiple risk factors for bowel resection and effectively used a scoring system to identify patients for optimal clinical management.

基金机构：Key Project of the Chongqing Natural Science Foundation (CSTC) [2008BA0021, cstc2012jjA0155]; Chongqing Health Planning Commission of Research Fund [2016MSXM044]

基金资助正文：This study was supported by grants from the Key Project of the Chongqing Natural Science Foundation (CSTC, 2008BA0021, cstc2012jjA0155) for collection, analysis and interpretation of data and Chongqing Health Planning Commission of Research Fund (No: 2016MSXM044) in writing the manuscript. The funding agency paid for the scholarships of the students involved in the research.