Epidemiology of childhood intussusception and determinants of recurrence and operation: analysis of national health insurance data between 1998 and 2007 in Taiwan.
BACKGROUND
To study the epidemiology of childhood intussusception and risk factors of recurrence and operation based on a nationwide data.


METHODS
Children with hospitalization due to intussusception (ICD9: 560.0) between 1998 and 2007 were identified from a national health insurance database. The incidence was calculated by age, sex, calendar year and month of admission. Recurrence and operation rates, duration and costs of hospitalization were analyzed.


RESULTS
A total of 8217 intussusception-related hospitalizations were identified in 7541 children. The incidence of intussusception peaked between 3 and 36 months of age. Male -to-female incidence rate ratio increased from 1.31 in the first year to 2.52 in the ninth year of life. The overall recurrence and operation rates were 7.9% and 24.9%, respectively. In children less than 1 year old, the recurrence rate was 10.1%, which decreased to 5.3% in children over 3 years old. Multiple logistic regression analysis showed that children receiving operation had a significantly lower risk of recurrence with an odds ratio (95% confidence interval) of 0.31 (0.24-0.41) after controlling for age and sex. There are significantly more cases occurring during the warmer months between May and October compared to the cooler months between November and April.


CONCLUSIONS
There was a male predominance of intussusception with a dynamic male-to-female incidence rate ratio. Children under 1 year of age have the highest recurrence and operation rates. Seasonal variation of intussusception was suspected in Taiwan.
Department of Pediatrics, Pingtung Christian Hospital, Pingtung, Taiwan. solomon.ccc@gmail.com
Solomon Chih-Cheng
SC
Chen
Jung-Der
JD
Wang
Hong-Yuan
HY
Hsu
Mee-Mee
MM
Leong
Teck-Siang
TS
Tok
Yow-Yue
YY
Chin
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007443:Intussusception / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D009313:National Health Programs; D012008:Recurrence; D012621:Seasons; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors