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

Yuan-Yang Yu1, Jia-Jie Zhang1, Ya-Ting Xu1

  • 1Department of Pediatric Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.

Frontiers in Pediatrics
|May 22, 2024
PubMed
Summary

A new nomogram helps predict the need for intestinal resection in children with intussusception and suspected necrosis after failed air-enema reduction. This tool aids in surgical decision-making for pediatric intussusception cases.

Keywords:
intestinal necrosisintestinal resectionintussusceptionnomogrampediatricspredictor

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Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Medical Imaging

Background:

  • Intussusception is a common surgical emergency in children.
  • Intestinal necrosis is a severe complication requiring surgical resection.
  • Predicting the need for resection after failed reduction is clinically significant.

Purpose of the Study:

  • To develop and validate a predictive nomogram for intestinal resection in pediatric intussusception with suspected intestinal necrosis.
  • To improve clinical decision-making in cases of failed air-enema reduction.

Main Methods:

  • Retrospective enrollment of children with intussusception and failed air-enema reduction.
  • Logistic regression analysis to identify predictive factors.
  • Development and validation of a nomogram using training and validation sets (3:1 ratio).
  • Evaluation of the nomogram using calibration curves and C-index.

Main Results:

  • A total of 547 children were analyzed; 133 required intestinal resection.
  • Four variables were identified: symptom duration, C-reactive protein, white blood cells, and ascites.
  • The developed nomogram achieved a concordance index of 0.871 (95% CI: 0.834-0.908).

Conclusions:

  • A validated nomogram effectively predicts intestinal resection in pediatric intussusception with suspected necrosis.
  • The nomogram can aid clinicians in managing children with intussusception after failed reduction.
  • This tool supports informed surgical decisions, potentially reducing unnecessary resections.