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Development of a nomogram for predicting postoperative Hirschsprung-associated enterocolitis
Weijun Zheng1, Weiming Chen1, Fei Chen2
1Department of Pediatric Surgery, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
Frontiers in Pediatrics
|October 2, 2025
Summary
Researchers identified key risk factors for Hirschsprung-associated enterocolitis (HAEC) after surgery. A predictive nomogram was developed to assess HAEC risk in patients with Hirschsprung disease (HSCR).
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Research
Background:
- Hirschsprung-associated enterocolitis (HAEC) is a serious complication following surgery for Hirschsprung disease (HSCR).
- Identifying risk factors and predicting HAEC incidence are crucial for improving patient outcomes.
Purpose of the Study:
- To analyze risk factors associated with postoperative HAEC.
- To develop and validate a nomogram for predicting HAEC in HSCR patients.
Main Methods:
- Retrospective analysis of 204 HSCR patients who underwent surgery.
- Univariate and multivariate logistic regression to identify risk factors.
- Nomogram construction and validation using ROC curves, calibration plots, and DCA curves.
Main Results:
- Postoperative HAEC occurred in 25.9% of patients.
- Significant risk factors included preoperative HAEC, HSCR type (long-segment or total colonic aganglionosis), lack of preoperative bowel preparation, and anastomotic complications.
- The nomogram demonstrated good discriminative ability (AUC=0.79), calibration, and clinical utility.
Conclusions:
- A validated nomogram can predict postoperative HAEC in HSCR patients.
- The nomogram serves as a valuable tool for risk assessment and early detection of HAEC.
