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Rising Incidence of Childhood Intussusception in Ontario: A Population-Based Study From 1997-2016
Mercedes Pilkington1, Arany Theivendram2, Susan B Brogly1,3
1Department of General Surgery, 9978Queen's University, Kingston, Canada.
Insights
Childhood intussusception incidence more than doubled in Ontario between 1997 and 2016. The condition most affects infants and young children, with increasing rates observed in those aged 6 months to 5 years.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Public Health
Background:
- Intussusception is a leading cause of bowel obstruction in children aged 3 months to 6 years.
- Understanding incidence patterns is crucial for pediatric healthcare planning.
Purpose of the Study:
- To describe the patterns of incident childhood intussusception in Ontario, Canada.
- To analyze trends in intussusception incidence over a 20-year period.
Main Methods:
- Retrospective longitudinal cohort study.
- Utilized population-based health administrative data from Ontario, Canada (1997-2016).
- Employed descriptive statistics, graphical analyses, and Poisson regression for trend analysis.
Main Results:
- Overall intussusception incidence in Ontario children (<18 years) was 3.3 cases/100,000 child-years.
- Incidence increased significantly from 0.9 to 2.3 cases/100,000 child-years between 1997 and 2016.
- Highest incidence observed in children aged 6-12 months (28.9 cases/100,000 child-years); rates increased 5-16% annually in children aged 6 months to 5 years.
Conclusions:
- Childhood intussusception incidence more than doubled in Ontario from 1997 to 2016.
- The rise in incidence, particularly in younger children, suggests an increase in idiopathic intussusception.
- A 10.7% readmission rate for recurrence within one year highlights the need for ongoing monitoring.
Background:
Intussusception is the most common cause of bowel obstruction in children aged 3 months to 6 years of age. We sought to describe patterns of incident childhood intussusception.
Methods:
A retrospective longitudinal cohort study utilizing population-based health administrative data and a validated case definition was used to identify patients <18 years of age treated for intussusception between January 1, 1997 and December 31, 2016 in Ontario, Canada. Descriptive statistics, graphical analyses, and a Poisson regression model were performed for trend analysis.
Results:
The overall incidence of intussusception in Ontario children (<18 years) was 3.3 cases/100,000 child years (cyrs), 95% CI [3.2.3.5]. The overall incidence increased from .9 cases/100,000 cyrs to 2.3 cases/100,000 cyrs. The highest incidence was in children aged 6-12 months at 28.9 cases/100,000 cyrs, 95% CI [26.2.31.9]. Incidence increased in all age-groups between 6 months and 5 years (at a rate of 5% to 16% per year; all P < .05). Month of year did not predict intussusception counts in a log-linear Poisson models, nor did rotavirus immunization implementation in 2011. There was a 3-fold variability across geographic areas in the province. There was a high rate of readmission for recurrence within 1 year (10.7%).
Conclusion:
The incidence of intussusception more than doubled in Ontario from 1997 to 2016. The incidence increased for children aged between 6 months and 5 years at a rate of 5-16% per year, suggesting that an increased rate of idiopathic intussusception is responsible for the increase in the province.
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