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Prediction of duodenal ulcers in children with Helicobacter pylori infection
Siyuan Zheng1, Chuchu Zheng1, Shijie Cai1
1The School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China.
Insights
Helicobacter pylori (HP) infection can cause duodenal ulcers (DUs) in children. A new predictive model using sex, melena, hemoglobin, and uric acid levels helps identify children with HP infection who may have DUs, aiding early diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Clinical Prediction Modeling
Background:
- Helicobacter pylori (HP) infection is a primary cause of duodenal ulcers (DUs) in pediatric populations.
- Duodenal ulcers can lead to severe complications, including gastrointestinal bleeding and intestinal perforation, posing life-threatening risks.
- Early diagnosis and intervention are crucial for managing DUs in children with HP infection.
Purpose of the Study:
- To develop and validate a predictive model for identifying duodenal ulcers (DUs) in children diagnosed with Helicobacter pylori (HP) infection.
- To provide a tool for primary care pediatricians to facilitate early detection and management of DUs.
- To improve clinical decision-making in pediatric HP infection cases.
Main Methods:
- Retrospective analysis of 456 children with HP infection from two hospitals.
- Utilized least absolute shrinkage and selection operator (LASSO) regression for variable selection, followed by logistic regression.
- Developed a nomogram-based predictive model incorporating identified risk factors.
Main Results:
- The final prediction model included sex, melena, hemoglobin level, and uric acid level.
- The model demonstrated good predictive performance with an area under the curve (AUC) of 0.740 for the training group and 0.728 for the validation group.
- Model calibration and consistency were confirmed by Hosmer-Lemeshow tests and calibration curves, indicating clinical utility.
Conclusions:
- Male children presenting with melena, low hemoglobin, and high uric acid levels warrant heightened suspicion for duodenal ulcers.
- Prompt referral to specialized pediatric endoscopic facilities is recommended for accurate diagnosis and treatment in high-risk cases.
- The developed predictive model can assist clinicians in identifying children with HP infection who require further investigation for DUs.
Background:
Helicobacter pylori (HP) infection is a major cause of duodenal ulcers (DUs) in children. DUs can lead to gastrointestinal bleeding and even intestinal perforation, both of which may be life-threatening. This study aimed to establish a predictive model for identifying DUs in children with HP infection, in order to assist primary care pediatricians with early diagnosis and intervention.
Methods:
A total of 456 children with HP infection admitted to Fujian Children's Hospital and Fujian Maternal and Child Health Hospital were retrospectively included. The training group comprised 307 patients from Fujian Children's Hospital, while the validation group consisted of 149 patients from Fujian Maternal and Child Health Hospital. The patients in the training group were categorized into the HP infection group or HP infection with DU group. Firstly, least absolute shrinkage and selection operator regression analysis was conducted, and the selected variables were subjected to logistic regression analysis to identify the predictors of DUs in children with HP infection. Finally, a nomogram was established for the model.
Results:
Sex, melena, hemoglobin level, and uric acid level were included in the final prediction model. The area under curve values for the internal training and external validation groups were 0.740 and 0.728, respectively. The Hosmer-Lemeshow tests and calibration curves indicated that the degree of fit and consistency of the model were satisfactory. These decision curve analyses indicated that the model has certain clinical application value.
Conclusions:
If male children with melena, decreased hemoglobin levels and high uric acid levels are clinically encountered, DUs require high vigilance, and the children should be promptly referred to a facility with pediatric endoscopic capabilities for further diagnosis and treatment.
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