Clinical prediction rules for failed nonoperative reduction of intussusception

Khorana, Jiraporn; Patumanond, Jayanton; Ukarapol, Nuthapong; Laohapensang, Mongkol; Visrutaratna, Pannee; Singhavejsakul, Jesda

doi:10.2147/tcrm.s115253

Cited by 13 publications

(14 citation statements)

References 17 publications

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“…The study explored the possibility of prereduction outcome prediction by clinical and radiological parameters in cases of infantile intussusception. A study by Khorana and colleagues in 2016 in Thailand was the first attempt at a systematic construction of a clinical score for intussusception with the aim to be used as a predictive tool for non-surgical treatment of the condition 11. This current study validated the Khorana et al score using another set of data from a university hospital in the same country, but with different practice details.…”

Section: Discussionmentioning

confidence: 80%

“…In Thailand, previous studies from our team and another study from Chiang Mai University (CMU) both found that low weight (<12 kg), prolonged symptoms, rectal bleeding, high body temperature, advanced invagination to the left side and unfavorable ultrasound findings were associated with failure of non-surgical reduction. Recently, researchers in CMU have constructed a scoring system for prediction of reduction failure called the ‘CMUI scoring system.’11 Their study demonstrated that a patient with intussusception with a high score (>11) had a significant likelihood of failed reduction. The objective of the current study was to validate the Chiang Mai University Intussusception (CMUI) scoring system with an independent external set of infantile intussusception data.…”

Section: Introductionmentioning

confidence: 99%

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Validation and modification of the ‘Chiang Mai University Intussusception scoring system’ used to predict failure of non-surgical treatment in infantile intussusception

Boonsanit

Kritsaneepaiboon

Chiengkriwate

et al. 2019

World Jnl Ped Surgery

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BackgroundThis study aimed to validate and modify the recently released Chiang Mai University Intussusception (CMUI) scoring system in predicting failure of non-surgical management of infantile intussusception.MethodsA retrospective review was conducted in 151 cases of infantile intussusception who were primarily treated with pneumatic reduction in our institute during 2008–2018. The analysis focused on the validation of the CMUI scoring system. Following this analysis, the scoring system was modified to be more suitable for our clinical practice, in which we perform pneumatic reduction in all cases.ResultsPneumatic reduction was successfully performed in 120/151 cases (79.5%). A high CMUI score was significantly associated with increased likelihood of failure at the positive likelihood ratio of 1.49 (sensitivity 25.8 and specificity 82.7). The area under the receiver operating characteristic curve (AUC) was 0.73. We modified the CMUI System in two ways, first by removing the item ‘method of reduction’ and replacing it with ‘hyponatremia’, and by changing the definition of low body weight to less than 9 kg. The modified CMUI had an AUC of 0.76. A high score (>9 points) on the modified version gave a positive likelihood ratio of 4.77 (sensitivity 53.0 and specificity 80.9).ConclusionIn infantile intussusception primarily treated with pneumatic reduction, the modified CMUI scoring system gave a better prediction reliability than the original.

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Validation and modification of the ‘Chiang Mai University Intussusception scoring system’ used to predict failure of non-surgical treatment in infantile intussusception

Boonsanit

Kritsaneepaiboon

Chiengkriwate

et al. 2019

World Jnl Ped Surgery

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“…The diagnosis of intussusception is determined mostly with ultrasonography and per the clinical case definition for the diagnosis of acute intussusception proposed by the Brighton Collaboration Intussusception Working Group [ 4 ]. Although there are surgical and nonsurgical treatment modalities, less than 5% of the cases might be reduced spontaneously without any intervention [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Is There a Causal Relationship between Intussusception and Food Allergy?

Aydın¹,

Beşer

YÜCEL

et al. 2017

Children

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Although intussusception and food allergy are common health problems in childhood, the relation between these two diseases remain obscure. The aim of this study is to investigate the relationship between food allergy and intussusception, and the factors associated with both. Patients diagnosed with intussusception by the Brighton Collaboration Intussusception Working Group criteria were prospectively investigated for food allergy per the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Guideline. They were analyzed per demographic features, clinical, physical and laboratory findings. There were eight (38.1%) patients diagnosed with food allergy, while 13 (61.9%) patients were non-allergic. The mean number of days of presenting symptoms was 1.13 days in the allergy group and 7.85 days in the non-allergy group. The mean number of intussusception attacks was 1.63 in the allergy group while 1 in the non-allergy group (p < 0.05, relative risk (RR) = 2.6). In the allergy group, one (13%) patient was followed up, six (75%) patients were reduced with pneumatic and one (13%) patient reduced manually. In the non-allergy group, four (31%) patients were followed up, six (46%) patients were reduced with pneumotic, one (7%) patient was reduced manually, and resection anastomosis was performed in two (15%) patients. Food allergy is an unrecognized associated factor for intussusception patients, which increases the risk for recurrence. Due to the small patient population, these results should be interpreted with caution.

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“…Preoperative prediction of failed nonoperative management is important for selecting patients requiring preoperative evaluation and preparation for anesthesia and planning the therapeutic management. However, there are still no clear conclusions about factors that may predict the need for surgical treatment after failed therapeutic enema 7–9 . The aim of this study was to identify the preoperative factors that could reliably predict failure of nonoperative management in pediatric intussusception.…”

mentioning

confidence: 99%

“…However, there are still no clear conclusions about factors that may predict the need for surgical treatment after failed therapeutic enema. [7][8][9] The aim of this study was to identify the preoperative factors that could reliably predict failure of nonoperative management in pediatric intussusception.…”

mentioning

confidence: 99%