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Biomarker-Based Prediction of Treatment Outcomes in Pediatric Intussusception: A Retrospective Cohort Study
Karla Pehar1, Danijela Jurić1, Kristina Jurković1
1School of Medicine, Catholic University of Croatia, Ilica 242, 10000 Zagreb, Croatia.
Insights
Admission erythrocyte count, platelet count, and potassium levels are linked to surgical needs in pediatric intussusception. These biomarkers show modest predictive value individually, suggesting a role in composite models for better outcomes.
Area of Science:
- Pediatric Gastroenterology
- Clinical Biomarker Research
- Surgical Outcome Prediction
Background:
- Intussusception is a critical pediatric condition requiring prompt management to prevent complications like bowel ischemia.
- Identifying early prognostic biomarkers is crucial for optimizing treatment strategies in pediatric intussusception.
Purpose of the Study:
- To investigate the association between admission biomarkers and treatment outcomes in pediatric intussusception.
- To identify potential predictors of surgical intervention in children with intussusception.
Main Methods:
- Retrospective analysis of 141 pediatric intussusception cases over ten years.
- Stratification of patients into spontaneous resolution, hydrostatic reduction, and surgical groups.
- Evaluation of demographic, clinical, radiological, and laboratory parameters, including erythrocyte count, platelet count, and potassium.
Main Results:
- Significant differences in erythrocyte count, hemoglobin, hematocrit, and platelets were observed across treatment groups.
- Multivariate analysis revealed erythrocyte count, platelet count, and potassium as independent predictors of surgical management.
- Lower erythrocyte counts, higher platelet counts, and lower potassium levels correlated with increased surgical likelihood.
Conclusions:
- Admission erythrocyte count, platelet count, and serum potassium are independently associated with the need for surgery in pediatric intussusception.
- These biomarkers demonstrate modest standalone predictive ability, indicating their potential utility in multivariable predictive models.
- Further prospective research is necessary to validate the incremental value of these biomarkers in composite models for clinical application.
Abstract:
Background/Objectives: Intussusception is a common pediatric emergency characterized by bowel telescoping, often leading to ischemia, necrosis, and perforation if untreated. Early identification of prognostic biomarkers could improve management strategies. This study aimed to evaluate the association between admission biomarkers and treatment outcomes in children with intussusception, to identify potential predictors. Methods: A retrospective analysis was conducted on 141 pediatric patients diagnosed with intussusception over ten years. Patients were stratified into three groups based on treatment outcome: spontaneous resolution, hydrostatic reduction, or surgery. Data collected included demographic, clinical, radiological, and laboratory parameters. Results: Among the cohort, 34% experienced spontaneous resolution, 27.7% underwent hydrostatic reduction, and 38.3% required surgery. Biomarkers such as erythrocyte count, hemoglobin, hematocrit, and platelets differed significantly across groups. Multivariate analysis identified erythrocyte count, platelet count, and potassium as variables independently associated with surgical management. Lower erythrocyte counts, higher platelet counts, and lower potassium were associated with increased likelihood of surgical intervention. The erythrocyte count, platelet count, and serum potassium showed ROC AUCs of 0.64, 0.65, and 0.70, respectively. Conclusions: Admission erythrocyte count, platelet count, and serum potassium were independently associated with the need for surgery but each showed only modest standalone discrimination. They are therefore best regarded as candidate variables for multivariable or composite predictive models rather than as standalone, clinically actionable triage markers. Further prospective studies are warranted to validate their incremental value within such models.