This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (13)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Pediatrics, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Nathan Kuppermann, MD, MPH; Teresa O'Dea, MD; Lee Pinckney, MD; Cynthia Hoecker, MD

Arch Pediatr Adolesc Med. 2000;154:250-255.

Objective  To identify predictors of intussusception in young children.

Design  A retrospective cross-sectional study.

Setting and Patients  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.20) in the univariate analysis were evaluated in a multiple logistic regression analysis. Variables retaining significance (P.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.

From the Department of Pediatrics and the Division of Emergency Medicine, Department of Internal Medicine, University of California, Davis School of Medicine (Dr Kupperman), the Department of Pediatrics, University of California, San Diego School of Medicine, La Jolla (Dr O'Dea), and the Divisions of Radiology (Dr Pinckney) and Emergency Medicine (Dr Hoecker), Children's Hospital and Health Center, San Diego, Calif.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Diagnosis of Intussusception
Klein et al.
CLIN PEDIATR 2004;43:343-347.
ABSTRACT  

Postreduction Management of Intussusception in a Children's Hospital Emergency Department
Bajaj and Roback
Pediatrics 2003;112:1302-1307.
ABSTRACT | FULL TEXT  

Association Between Antibiotic Use and Primary Idiopathic Intussusception
Spiro et al.
Arch Pediatr Adolesc Med 2003;157:54-59.
ABSTRACT | FULL TEXT  

Help in Diagnosing Intussusception
JWatch Emergency Med. 2000;2000:8-8.
FULL TEXT