title: UK intussusception audit: a national survey of practice and audit of reduction rates.
abstract: OBJECTIVE
  To define current UK reduction practice and the reductions rates achieved.
  
  
  METHODS
  Electronic surveys were sent to radiologists at 26 UK centres. This assessed methods of reduction, equipment, personnel, and protocol usage. Standardized audit proforma were also sent to evaluate all reductions performed in 2011.
  
  
  RESULTS
  Twenty-two of 26 centres (85%) replied. All used air enema under fluoroscopic guidance. Equipment was not standardized but could be broadly categorized into hand-pumped air-supply systems (seven centres) and pressurized air systems (15 centres). Seventeen centres followed a protocol based on British Society of Paediatric Radiologists (BSPR) guidelines. In 21 of the 22 centres a consultant paediatric radiologist led reductions and only 12 centres reported a surgeon being present. Three hundred and ten cases were reported across 22 centres. Cases per centre ranged from 0-31 (median 14). Reduction rates varied from 38-90% (median 71%). The overall perforation rate was 2.5%. Caseload did not significantly correlate with reduction rate, and there was no significant difference between the two types of equipment used. Median reduction rates were 15% higher in centres with a surgeon present at reduction (p < 0.05).
  
  
  CONCLUSIONS
  Intussusception care in the UK lacks standardization of equipment and personnel involved. National reduction rates are lower than in current international literature. Improved standardization may lead to an improvement in reduction rates and a surgeon should always be present at reduction.
authors.affiliation: Department of Paediatric Surgery, St George's Hospital, Tooting, London, UK. Electronic address: edhannon1@yahoo.co.uk.
authors.forename: Edward
authors.initials: E
authors.lastname: Hannon
authors.affiliation: Department of Paediatric Radiology, St George's Hospital, Tooting, London, UK.
authors.forename: Rhianydd
authors.initials: R
authors.lastname: Williams
authors.affiliation: Department of Paediatric Radiology, St George's Hospital, Tooting, London, UK.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Allan
authors.affiliation: Department of Paediatric Surgery, St George's Hospital, Tooting, London, UK.
authors.forename: Bruce
authors.initials: B
authors.lastname: Okoye
mesh_terms: D054869:Clinical Audit; D004733:Enema / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D007223:Infant; D007231:Infant, Newborn; D007443:Intussusception / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology