Risk Factors Associated with the Need for Operative Treatment of Intussusception in Children

Heontak Ha; Jayun Cho; Jinyoung Park

doi:10.13029/jkaps.2014.20.1.17

Journal List > J Korean Assoc Pediatr Surg > v.20(1) > 1071939

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Ha, Cho, and Park: Risk Factors Associated with the Need for Operative Treatment of Intussusception in Children

Original Article

Journal of the Korean Association of Pediatric Surgeons 2014; 20(1): 17-22.

Published online: 30 June 2014

DOI: https://doi.org/10.13029/jkaps.2014.20.1.17

Risk Factors Associated with the Need for Operative Treatment of Intussusception in Children

Heontak Ha, Jayun Cho, Jinyoung Park

Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea.

Correspondence: Jinyoung Park, Department of Surgery, Kyungpook National University Hospital, 130, Dongdeok-ro, Chung-gu, Daegu 700-721, Korea. Tel: 053-420-5612, Fax: 053-421-0510, kpnugs@knu.ac.kr

Received 25 May 2014 Accepted 8 June 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The aim of this study was to identify the risk factor related to the need for operative treatment and avoid unnecessary non-operative management for intussusception in children. We retrospectively reviewed medical records of patient treated for intussusception at our institution between January 2006 and January 2013. Clinical features such as gender, age, seasonal variation, symptoms and signs, treatment results were analyzed. Univariate and multivariate analyses including a chi-square test for categorical variables and logistic regression analysis were performed. During the study period, 356 patients were treated for intussusception. 328 (92.1%) was treated successfully by the non-operative pneumoreduction, and 28 (7.9%) required operative management. On univariate analysis, risk factors which were related to the need for operative treatment were age, vomiting, bloody stool, lethargy, and symptoms duration. A logistic regression analysis in order to assess for independent predictors of operative treatment was performed. Age (<6 vs ≥12 months) (OR 4.713, 95% CI 1.198~18.539, p=0.027) and symptoms duration longer than 48 hours (OR 4.534, 95% CI 1.846~11.137, p=0.001) were significantly associated with a requirement for operative treatment. We conclude that younger age and a longer duration of symptoms (≥ 48 hours) are the independent risk factor related to the need for operative treatment for intussusception. Early surgical intervention or transfer to a hospital with pediatric surgical capabilities should be considered for patients with these findings.

Keywords: Intussusception, Operative treatment, Children, Risk factor

Figures and Tables

Fig. 1

Monthly distribution of intussusception.

Table 1

Univariate Comparison between the Non-operative and Operative Group

^*Cochran-Armitage test for linear trend.

Table 2

Demographics and Outcomes of Operative Group

Table 3

Logistic Regression Analysis for Risk Factors of Operative Treatment

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