Lactic acid level as an outcome predictor in pediatric patients with intussusception in the emergency department

Lee, Jun Young; Byun, Young-Hoon; Park, Jun-Sung; Lee, Jong Seung; Ryu, Jeong-Min; Choi, Soo Jung

doi:10.1186/s12887-020-02095-9

Cited by 6 publications

(7 citation statements)

References 18 publications

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“…Indeed, differences were found in the serum lactate levels and base excess, which are possible markers of organ failure, in patients assessed before and after the COVID-19 outbreak. In particular, high serum lactate levels have been associated with poor outcomes of intussusception [26]. Although air enema reduction was delayed for about 0.5 h in patients who visited during the pandemic period, the duration of illness in these patients was similar to that in patients who visited during the pre-pandemic period.…”

Section: Discussionmentioning

confidence: 92%

“…The COVID-19 pandemic resulted in patient reluctance to visit the emergency department (ED) [19,20], which can delay various surgical emergencies and can worsen their clinical courses [21][22][23]. Especially in intussusception, the most common surgical emergency in young children, a delay in visiting the ED and in intervention can increase the risks of surgical reduction and poor outcomes [24][25][26][27]. Therefore, this study assessed the changes in the incidence and clinical characteristics of intussusception between the pre-pandemic and COVID-19 pandemic periods.…”

Section: Introductionmentioning

confidence: 99%

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Decreased Incidence of Pediatric Intussusception during COVID-19

et al. 2021

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Coronavirus disease 2019 (COVID-19) changed the epidemiology of various diseases. The present study retrospectively investigates the epidemiologic and clinical changes in pediatric intussusception for ages ≤ 7 years before (February 2019–January 2020) and after (February 2020–January 2021) the COVID-19 outbreak in a single pediatric emergency department of a university-affiliated tertiary hospital. The incidence of communicable diseases—defined as infectious diseases with the potential for human-to-human transmission via all methods, non-communicable diseases, and intussusception were decreased following the COVID-19 outbreak (15,932 to 3880 (24.4%), 12,994 to 8050 (62.0%), and 87 to 27 (31.0%), respectively). The incidence of intussusception correlated significantly with the change in incidence of communicable diseases (Poisson log-linear regression, odds ratio = 2.15, 95% CI = 1.08–4.26, and p = 0.029). Compared with the pre-pandemic period, patients of the pandemic period showed higher proportions of pathologic leading point (PLP) and hospitalization (14.8% vs. 2.3% and 18.5% vs. 4.6%, respectively), lower base excesses (−4.8 mmol/L vs. −3.6 mmol/L), and higher lactate concentrations (1.7 mmol/L vs. 1.5 mmol/L). The incidence of pediatric intussusception decreased after the COVID-19 pandemic. This reduced incidence may be related to the reduced incidence of communicable diseases. However, the proportions of more severe diseases and PLPs were higher after the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Decreased Incidence of Pediatric Intussusception during COVID-19

et al. 2021

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“…The result was that patients who received intravenous fluids before 30 minutes had a 12% shorter length of stay compared to patients who received intravenous fluids after 30 minutes (HR 1.14; 95% CI, 1.02-1.27). 4,8,9 This study has several limitations that might have an influence on the results of this study which showed a negative correlation between lactic acid levels and the incidence of perforated appendicitis. This study had a sample size that was less than the minimum number of samples because the study was conducted in a type A general hospital (main referral hospital) where cases of acute appendicitis were rare.…”

Section: Discussionmentioning

confidence: 88%

Correlation Analysis of Lactic Acid Level as A Predictor of Severity of Patients with Acute Appendicitis

Rudiman

Ruchimat

Rossy

2023

MKB

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Perforated appendicitis is a leading cause of morbidity and mortality in all appendicitis cases, both for adults and children. Delay in preoperative diagnosis is the main reason for perforation. In previous studies, it was revealed that diagnostic modalities such as radiological examination and the current scoring system have not been able to predict the onset of perforated appendicitis. Serological biomarkers of lactic acid are associated with intestinal obstruction and ischemia. The increase in the serological value of lactic acid in perforated appendicitis compared to acute one was shown to increase significantly by 0.25 mmol/L (p<0.05) according to a previous study. This study aimed to determine the correlation between lactic acid level and the severity of appendicitis in patients visiting Dr. Hasan Sadikin General Hospital. This was a cross-sectional prospective analytic observational study on adult patients diagnosed with appendicitis who were admitted to the emergency room of Dr. Hasan Sadikin General Hospital from January 1, 2021 to June 1, 2021. Data analysis was performed using bivariate analysis and correlation tests of difference. This study involved 54 subjects with a mean lactic acid level of 2,5093 mmol/L (0.9 mmol/L - 11.8 mmol/L). In the complicated appendicitis group, 20 subjects (37%) was found to experience an increase in lactic acid (OR 1.07; 95% CI: -0.03-0.22; p=0.14). The correlation analysis showed the direction of negative correlation. Thus, it is concluded that there is no significant correlation between lactic acid level and the severity of appendicitis in patients with appendicitis.

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“…Intussusception is a common cause of bowel resection in infants and young children [ 7 , 8 ]. It is well-established that prompt identification and management are crucial for reducing the incidence of intestinal necrosis resulting from intussusception.…”

Section: Discussionmentioning

confidence: 99%

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

Xia,

Chen,

Liu

et al. 2024

BMC Gastroenterol

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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 (β). 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 β 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.

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Lactic acid level as an outcome predictor in pediatric patients with intussusception in the emergency department

Cited by 6 publications

References 18 publications

Decreased Incidence of Pediatric Intussusception during COVID-19

Decreased Incidence of Pediatric Intussusception during COVID-19

Correlation Analysis of Lactic Acid Level as A Predictor of Severity of Patients with Acute Appendicitis

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

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