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Published on: April 26, 2019
Recurrence of pediatric intussusception: A nationwide population-based descriptive study in Taiwan
Chao-Yang Chang1, Yu-Ying Chen1, Chih-Hsuan Lin1
1Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.
Insights
Recurrent intussusception risk is lower in older children and after surgery. Male infants face a higher risk, necessitating close follow-up for those initially treated non-surgically.
Area of Science:
- Pediatric Emergency Medicine
- Gastroenterology
- Epidemiology
Background:
- Intussusception is a common pediatric emergency.
- Recurrent intussusception occurs frequently after initial treatment.
- Identifying risk factors for recurrence is crucial for patient management.
Purpose of the Study:
- To investigate risk factors for recurrent intussusception in children aged ≤3 years.
- To analyze the association between age, sex, birth weight, gestational age, and initial treatment with intussusception recurrence.
- To inform clinical practice regarding the prevention and management of recurrent intussusception.
Main Methods:
- A cohort study was conducted using Taiwanese healthcare databases (January 2007 - December 2015).
- Included were 5341 children aged ≤3 years diagnosed with intussusception.
- Multivariable logistic regression analysis was employed to identify risk factors.
Main Results:
- Children aged 2-3 years had a lower risk of recurrence (aOR=0.62) compared to infants <1 year.
- Surgical treatment significantly decreased recurrence risk (aOR=0.64).
- Male patients exhibited a higher risk of recurrent intussusception (aOR=1.41) than females.
Conclusions:
- Surgical intervention and older age at initial diagnosis are associated with reduced risk of intussusception recurrence.
- Male sex is a significant risk factor for recurrent intussusception.
- Close monitoring is recommended for infants receiving non-surgical treatment due to higher recurrence potential.
Abstract:
Intussusception is frequently observed pediatric emergency that is often followed by recurrent intussusception after initial treatment. This study investigated the risk factors associated with recurrent intussusception in children aged ≤ 3 years. Between January 2007 and December 2015, a cohort study was conducted by linking the Taiwan Maternal and Child Health Database to the Birth Certificate Application database and the National Health Insurance Research Database in Taiwan. Patients aged ≤ 3 years with intussusception diagnosis and related treatment were included in our study. Multivariable logistic regression was used to analyze the risk factors associated with recurrent intussusception. In total, 5341 children with intussusception aged ≤ 3 years were enrolled in our cohort. The adjusted odds ratio (aOR) for recurrent intussusception in children aged 2 to 3 years was 0.62 (95% confidence interval [CI]: 0.47-0.82) compared with children aged < 1 year, and surgery decreased the risk of recurrent intussusception (aOR = 0.64, 95% CI: 0.46-0.88). Male patients had higher risk of recurrent intussusception than female patients had (aOR = 1.41, 95% CI: 1.13-1.75). Higher birth weight may increase the risk of recurrent intussusception, but this association was not statistically significant. Furthermore, gestational age did not seem to affect the risk of recurrent intussusception. Surgical treatment and delayed onset of intussusception are associated with a reduced risk of recurrent intussusception; males are associated with increased risk of recurrent intussusception. In addition, we suggest that in early infancy, patients who received non-surgical treatment as the initial treatment for intussusception should be closely followed up for potential recurrence of intussusception.
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