Abstract / Summary
Background and aimDelayed diagnosis and referral are major contributing factors to morbidity and mortality in childhood intussusception in low-and middle-income countries.This study aimed to develop a score for predicting the need for bowel resection in childhood intussusception in low-resource settings. MethodsThis retrospective study was conducted at the pediatric surgical units of three institutions in South-West Nigeria.This study included children aged between 0 and 36 months managed for intussusception between January 2006 and December 2019.Statistical analysis was done using the chi-square, Fisher's exact test, Mann-Whitney U test, and multivariate logistic regression depending on data type and distribution. ResultsA total of 212 children were included in this study, and the need for bowel resection was assessed.Following univariate analysis, statistically significant variables were included in multivariate analysis.Five variables, abdominal distension, fever, age, abdominal pain, and anemia independently predicted the outcome of bowel resection.The regression analysis was used to compute the scoring system, giving 13 points for abdominal distension, 10 for fever, 9 for abdominal pain, 10 for anemia, and -1 for each month of age.There was a positive correlation between the scores and the risk of bowel resection (p<0.001).The area under the receiver operating characteristic (ROC) curve for this score, describing its prediction ability, was 74.8% (p<0.0001). ConclusionThe scoring system predicts the need for bowel resection in children with intussusception.This can promote early referral of pediatric intussusception to the pediatric surgeon, who in turn can be guided to operate early in patients who may require bowel resection.