Analysis of the predictors of surgical treatment and intestinal necrosis in children with intestinal obstruction

Wu, Kun; Xiao, Jianghong; Yan, Jing; Liu, Ruiqi; Yang, Jiale; Xiao, Yao; Xiang, Deng; Yu, Ming; Zhang, Shouhua

doi:10.1016/j.jpedsurg.2020.07.017

Cited by 5 publications

(7 citation statements)

References 22 publications

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“…Our laboratory study suggested WBCs was an independent early predictor in diagnosing intestinal resection in pediatric intussusception suspecting intestinal necrosis (OR = 1.110; 95% CI, 1.048–1.176; p = 0.002) and significantly higher in intestinal resection than non-intestinal resection, which was probably related to the prolongation of intestinal damage with massive leukocyte releasing into the bloodstream. Coherent with the observations we made, Chen et al ( 24 ) concluded WBCs increased more in severe intestinal obstruction than less severe cases. A study conducted on childhood intussusception after surgery also came to the same conclusion that CRP and WBCs levels were higher in patients who underwent bowel resection than those who underwent manual surgical reduction merely ( 25 ).…”

Section: Discussionsupporting

confidence: 66%

“…Elevated CRP, WBCs, and other inflammatory factors are common. CRP level is a dynamic inflammation indicator well reflecting systemic inflammation elevating in response to inflammatory reactions, resistance to bacterial infections and tissue damage such as acute appendicitis ( 23 ), incarcerated groin hernia ( 10 ), intestinal obstruction ( 24 ), etc. As shown in our nomogram, CRP significantly contributed to intestinal necrosis, with higher CRP level greatly increasing the risk of intestinal necrosis and indicating the severity of the illness.…”

Section: Discussionmentioning

confidence: 99%

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Developing and validating a nomogram for early predicting the need for intestinal resection in pediatric intussusception

Yu,

Zhang,

et al. 2024

Front. Pediatr.

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PurposeDevelop and validate a nomogram for predicting intestinal resection in pediatric intussusception suspecting intestinal necrosis.Patients & methodsChildren with intussusception were retrospectively enrolled after a failed air-enema reduction in the outpatient setting and divided into two groups: the intestinal resection group and the non-intestinal resection group. The enrolled cases were randomly selected for training and validation sets with a split ratio of 3:1. A nomogram for predicting the risk of intestinal resection was visualized using logistic regression analysis with calibration curve, C-index, and decision curve analysis to evaluate the model.ResultsA total of 547 cases were included in the final analysis, of which 414 had non-intestinal necrosis and 133 had intestinal necrosis and underwent intestinal resection. The training set consisted of 411 patients and the validation cohort included 136 patients. Through forward stepwise regression, four variables (duration of symptoms, C-reaction protein, white blood cells, ascites) were selected for inclusion in the nomogram with a concordance index 0.871 (95% confidence interval: 0.834–0.908).ConclusionWe developed a nomogram for predicting intestinal resection in children with intussusception suspecting intestinal necrosis after a failed air-enema based on multivariate regression. This nomogram could be directly applied to facilitate predicting intestinal resection in pediatric intussusception suspecting necrosis.

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Developing and validating a nomogram for early predicting the need for intestinal resection in pediatric intussusception

Yu,

Zhang,

et al. 2024

Front. Pediatr.

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“…In Chen's study, they found that patients underwent intestinal resection due to intestinal necrosis had significantly higher WBCs count than those without any resection ( 18 ). In 2020, Chen et al ( 19 ) developed a prediction model that used WBCs count as an important risk factor. Chen's prediction model has been validated to predict the occurrence of intestinal necrosis well ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

“…In 2020, Chen et al ( 19 ) developed a prediction model that used WBCs count as an important risk factor. Chen's prediction model has been validated to predict the occurrence of intestinal necrosis well ( 19 ). It has been reported that CK-MB in blood could reflect ischemia of intestinal smooth muscle to some extent ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

“…Chen's prediction model has been validated to predict the occurrence of intestinal necrosis well ( 19 ). It has been reported that CK-MB in blood could reflect ischemia of intestinal smooth muscle to some extent ( 19 ). Intestinal ischemia will result in intestinal necrosis, causing the synthesis of large amounts of CK or CK-MB into the blood.…”

Section: Discussionmentioning

confidence: 99%

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Developing a nomogram for predicting surgical intervention in pediatric intussusception after hydrostatic reduction

Wang

Xia

et al. 2023

Front. Pediatr.

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PurposeThe aim of this study was to develop and validate a nomogram for predicting surgical intervention in pediatric intussusception after hydrostatic reduction.MethodsChildren with intussusception who had treated with sonographically guided saline hydrostatic reduction as an initial treatment were enrolled in this study. The enrolled patients were randomly selected for training and validation sets, and the split ratio was 7:3. The medical records of enrolled patients were retrospectively reviewed. The patients were divided into a surgery and a non-surgery group according to the results of the nonsurgical reduction. A model for predicting the risk of surgical treatment was virtualized by the nomogram using logistic regression analysis.ResultsThe training set consisted of 139 patients and the validation set included 74. After logistic regression analysis using training set, duration of symptoms, bloody stools, white blood cells (WBCs), creatine kinase isoenzyme (CK-MB), long-axis diameter, poor prognostic signs by ultrasound and mental state were identified as the independent predictors of surgical intervention for intussusception. A model that incorporated the above independent predictors was developed and presented as a nomogram. The C-index of the nomogram in the validation set was 0.948 (95% CI, 0.888–1.000). The calibration curve demonstrated a good agreement between prediction and observation. The decision curve analysis (DCA) curve showed that the model achieved a net benefit across all threshold probabilities.ConclusionBased on the predictors of duration of symptoms, bloody stools, WBCs, CK-MB, long-axis diameter, poor prognostic signs by ultrasound and mental state, we developed a nomogram for predicting surgical intervention after hydrostatic reduction. This nomogram could be applied directly to facilitate pre-surgery decision for pediatric intussusception.

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Correlation between pathology indicators and intestinal necrosis in pediatric intussusception

BUDIANANTI,

HARIASTAWA,

MATULATAN

2024

Chirurgia

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Analysis of the predictors of surgical treatment and intestinal necrosis in children with intestinal obstruction

Cited by 5 publications

References 22 publications

Developing and validating a nomogram for early predicting the need for intestinal resection in pediatric intussusception

Developing and validating a nomogram for early predicting the need for intestinal resection in pediatric intussusception

Developing a nomogram for predicting surgical intervention in pediatric intussusception after hydrostatic reduction

Correlation between pathology indicators and intestinal necrosis in pediatric intussusception

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