title: Risk factors for pediatric intussusception complicated by loss of intestine viability in China from June 2009 to May 2014: a retrospective study.
abstract: OBJECTIVE
  Intussusception is one of the most common causes of acute abdominal emergencies in infants and preschool children. Loss of intestine viability is the most serious complication of intussusception. This study aimed to investigate the risk factors for loss of intestine viability in pediatric intussusception cases among children.
  
  
  METHODS
  Data were collected for operative pediatric intussusception cases (N = 316) from medical records of 5,537 hospitalized children due to intussusception between June 2009 and May 2014 in a pediatric surgery department of an academic teaching hospital in China. Seventy-six patients (24.1 %) of the operated intussusception cases had complication of loss intestine viability.
  
  
  RESULTS
  Pediatric intussusception cases with loss of intestine viability and without loss of intestine viability were similar in terms of their age, malformation and season of admission. The median time of the duration from onset of symptoms to operative treatment was 23 h (range 3-90 h). The loss of intestine viability group of the intussusception cases was significantly associated with longer length of history (P = 0.000). Receiver operating characteristic curve analysis for length of history showed that the optimal ratio of sensitivity (0.70) and specificity (0.73) was calculated for the length of history longer than 27.5 h regarding loss of intestine viability of intussusception. In addition, the risk of loss of intestine viability was higher for female (31 %) than for male (20.8 %) (P = 0.049). The loss of intestine viability rate was also significantly higher in ileo-ileal intussusception cases than that of the other types (P = 0.033). However, there is no difference among the other groups.
  
  
  CONCLUSIONS
  The result of our risk factor analysis for loss of intestine viability in pediatric intussusception cases may help develop a predictability index to prevent the complication to happen. Further prospective studies are required to confirm our findings.
authors.affiliation: Department of Pediatric Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Xian-Ming
authors.initials: XM
authors.lastname: Yao
authors.forename: Zhong-Liang
authors.initials: ZL
authors.lastname: Chen
authors.forename: De-Lei
authors.initials: DL
authors.lastname: Shen
authors.forename: Qi-Shuang
authors.initials: QS
authors.lastname: Zhou
authors.forename: Song-Song
authors.initials: SS
authors.lastname: Huang
authors.forename: Zu-Ren
authors.initials: ZR
authors.lastname: Cai
authors.forename: Yu-Long
authors.initials: YL
authors.lastname: Tong
authors.forename: Meng
authors.initials: M
authors.lastname: Wang
authors.forename: Yi
authors.initials: Y
authors.lastname: Ren
authors.forename: Xin-He
authors.initials: XH
authors.lastname: Lai
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Chen
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007410:Intestinal Diseases / Q000209:etiology / Q000503:physiopathology; D007443:Intussusception / Q000150:complications / Q000503:physiopathology*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014022:Tissue Survival