Bypassing the Delay: Directing Pediatric Intussusception Cases to the OR Through Inflammatory Marker Assessment

Area of Science:

• Gastroenterology
• Surgical Pathology
• Biomarker Discovery

Background:

• Intestinal necrosis is a severe complication of intussusception.
• Systemic inflammation markers, including ratios like CAR and LCR, are explored as predictors for inflammatory conditions.

Purpose of the Study:

• To evaluate the effectiveness of inflammatory markers (NLR, PLR, LCR, CAR) in predicting intestinal necrosis and the need for resection in intussusception patients.
• To identify which inflammatory marker combinations best correlate with intraoperative findings of intestinal necrosis.

Main Methods:

• Retrospective cohort study of 100 intussusception patients requiring surgery.
• Patients divided into groups based on intestinal resection.
• Analysis of inflammatory marker ratios (NLR, PLR, LCR, CAR) and their correlation with surgical outcomes.

Main Results:

• Significantly higher mean CRP-to-albumin ratio (CAR) in the resection group (15.27) vs. non-resection group (3.56).
• Significantly lower mean lymphocyte-to-CRP ratio (LCR) in the resection group (0.116) vs. non-resection group (0.509).
• ROC analysis showed excellent AUC for LCR (cutoff 0.1233, sensitivity 85.7%, specificity 90%) and CAR (cutoff 7.73, sensitivity 92.6%, specificity 90%) in predicting resection needs. CAR increase by 1 unit raised resection risk by 1.42.

Conclusions:

• CAR is a statistically significant predictor of intestinal resection need in intussusception.
• LCR provides valuable information and should be used with CAR for surgical decision-making.
• Utilizing CAR (cutoff 7.73) and LCR (cutoff 0.1233) can help prioritize patients, avoid delays, and improve outcomes.