Predictors of intussusception in young children.
OBJECTIVE
To identify predictors of intussusception in young children.


METHODS
A retrospective cross-sectional study.


METHODS
A consecutive sample of children younger than 5 years on whom contrast enemas were performed because of suspected intussusception seen at an urban children's hospital from 1990 to 1995.


METHODS
We evaluated historical, clinical, and radiographic variables. Variables documented in 75% or more of the medical records and associated with intussusception (P< or =.20) in the univariate analysis were evaluated in a multiple logistic regression analysis. Variables retaining significance (P< or =.05) in the multivariate analysis were considered independent predictors of intussusception. We used bootstrap resampling techniques to validate the multivariate model.


RESULTS
Sixty-eight (59%) of the 115 patients had intussusception. Univariate predictors of intussusception included male sex, age younger than 2 years, history of emesis, rectal bleeding, lethargy, abdominal mass, and a highly suggestive abdominal radiograph. In the multivariate analysis, we identified only 4 independent predictors (adjusted odds ratio; 95% confidence interval): a highly suggestive abdominal radiograph (18.3; 4.0-83.1), rectal bleeding (17.3; 2.9-104.0), male sex (6.2; 1.2-32.3), and a history of emesis (13.4; 1.4-126.0). We identified 3 of these 4 variables (all but emesis) as independent predictors in more than 50% of 1000 bootstrap data samples.


CONCLUSIONS
Rectal bleeding, a highly suggestive abdominal radiograph, and male sex are variables independently associated with intussusception in a cohort of children suspected of having this diagnosis. Knowledge of these variables may assist in clinical decision making regarding diagnostic and therapeutic interventions.
Kuppermann
N
N
Department of Pediatrics, University of California, Davis School of Medicine, Sacramento 95817, USA. nkuppermann@ucdavis.edu
O'Dea
T
T
Pinckney
L
L
Hoecker
C
C
D002140:California; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D007223:Infant; D007443:Intussusception / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012189:Retrospective Studies