Prognostic indicators for failed nonsurgical reduction of intussusception

© 2016 Khorana et al. Purpose: To identify the risk factors for failure of nonsurgical reduction of intussusception. Methods: Data from intussusception patients who were treated with nonsurgical reduction in Chiang Mai University Hospital and Siriraj Hospital between January 2006 and December 2012 w...

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Main Authors: Jiraporn Khorana, Jesda Singhavejsakul, Nuthapong Ukarapol, Mongkol Laohapensang, Jakraphan Siriwongmongkol, Jayanton Patumanond
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Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/55378
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spelling th-cmuir.6653943832-553782018-09-05T03:14:44Z Prognostic indicators for failed nonsurgical reduction of intussusception Jiraporn Khorana Jesda Singhavejsakul Nuthapong Ukarapol Mongkol Laohapensang Jakraphan Siriwongmongkol Jayanton Patumanond Chemical Engineering Medicine Pharmacology, Toxicology and Pharmaceutics Social Sciences © 2016 Khorana et al. Purpose: To identify the risk factors for failure of nonsurgical reduction of intussusception. Methods: Data from intussusception patients who were treated with nonsurgical reduction in Chiang Mai University Hospital and Siriraj Hospital between January 2006 and December 2012 were collected. Patients aged 0-15 years and without contraindications (peritonitis, abdominal X-ray signs of perforation, and/or hemodynamic instability) were included for nonsurgical reduction. The success and failure groups were divided according to the results of the reduction. Prognostic indicators for failed reduction were identified by using generalized linear model for exponential risk regression. The risk ratio (RR) was used to report each factor. Results: One hundred and ninety cases of intussusception were enrolled. Twenty cases were excluded due to contraindications. A total of 170 cases of intussusception were included for the final analysis. The significant risk factors for reduction failure clustered by an age of 3 years were weight <12 kg (RR =1.48, P=0.004), symptom duration >3 days (RR =1.26, P<0.001), vomiting (RR =1.63, P<0.001), rectal bleeding (RR =1.50, P<0.001), abdominal distension (RR =1.60, P=0.003), temperature >37.8°C (RR =1.51, P<0.001), palpable abdominal mass (RR =1.26, P<0.001), location of mass (left over right side) (RR =1.48, P<0.001), poor prognostic signs on ultrasound scans (RR =1.35, P<0.001), and method of reduction (hydrostatic over pneumatic) (RR =1.34, P=0.023). The prediction ability of this model was 82.21% as assessed from the area under the receiver operating characteristic curve. Conclusion: The identified prognostic factors for the nonsurgical reduction failure may help to predict the reduction outcome and provide information to the parents. 2018-09-05T02:55:00Z 2018-09-05T02:55:00Z 2016-08-09 Journal 1178203X 11766336 2-s2.0-84983552134 10.2147/TCRM.S109785 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84983552134&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/55378
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Chemical Engineering
Medicine
Pharmacology, Toxicology and Pharmaceutics
Social Sciences
spellingShingle Chemical Engineering
Medicine
Pharmacology, Toxicology and Pharmaceutics
Social Sciences
Jiraporn Khorana
Jesda Singhavejsakul
Nuthapong Ukarapol
Mongkol Laohapensang
Jakraphan Siriwongmongkol
Jayanton Patumanond
Prognostic indicators for failed nonsurgical reduction of intussusception
description © 2016 Khorana et al. Purpose: To identify the risk factors for failure of nonsurgical reduction of intussusception. Methods: Data from intussusception patients who were treated with nonsurgical reduction in Chiang Mai University Hospital and Siriraj Hospital between January 2006 and December 2012 were collected. Patients aged 0-15 years and without contraindications (peritonitis, abdominal X-ray signs of perforation, and/or hemodynamic instability) were included for nonsurgical reduction. The success and failure groups were divided according to the results of the reduction. Prognostic indicators for failed reduction were identified by using generalized linear model for exponential risk regression. The risk ratio (RR) was used to report each factor. Results: One hundred and ninety cases of intussusception were enrolled. Twenty cases were excluded due to contraindications. A total of 170 cases of intussusception were included for the final analysis. The significant risk factors for reduction failure clustered by an age of 3 years were weight <12 kg (RR =1.48, P=0.004), symptom duration >3 days (RR =1.26, P<0.001), vomiting (RR =1.63, P<0.001), rectal bleeding (RR =1.50, P<0.001), abdominal distension (RR =1.60, P=0.003), temperature >37.8°C (RR =1.51, P<0.001), palpable abdominal mass (RR =1.26, P<0.001), location of mass (left over right side) (RR =1.48, P<0.001), poor prognostic signs on ultrasound scans (RR =1.35, P<0.001), and method of reduction (hydrostatic over pneumatic) (RR =1.34, P=0.023). The prediction ability of this model was 82.21% as assessed from the area under the receiver operating characteristic curve. Conclusion: The identified prognostic factors for the nonsurgical reduction failure may help to predict the reduction outcome and provide information to the parents.
format Journal
author Jiraporn Khorana
Jesda Singhavejsakul
Nuthapong Ukarapol
Mongkol Laohapensang
Jakraphan Siriwongmongkol
Jayanton Patumanond
author_facet Jiraporn Khorana
Jesda Singhavejsakul
Nuthapong Ukarapol
Mongkol Laohapensang
Jakraphan Siriwongmongkol
Jayanton Patumanond
author_sort Jiraporn Khorana
title Prognostic indicators for failed nonsurgical reduction of intussusception
title_short Prognostic indicators for failed nonsurgical reduction of intussusception
title_full Prognostic indicators for failed nonsurgical reduction of intussusception
title_fullStr Prognostic indicators for failed nonsurgical reduction of intussusception
title_full_unstemmed Prognostic indicators for failed nonsurgical reduction of intussusception
title_sort prognostic indicators for failed nonsurgical reduction of intussusception
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84983552134&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/55378
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