Cohort analysis of pediatric intussusception score to diagnose intussusception

Table 1 Characteristics of children in intussusception and non-intussusception groups

Parameter	Intussusception (n = 97)	Non-intussusception (n = 54)	P value
Age (yr)	2.06 (2.67)	2.78 (2.92)	0.121
Age 6 mo to 2 years	64 (65.3)	23 (41.8)	0.005
Male gender	62 (63.3)	35 (63.6)	0.964
Hospital setting
Emergency department to ward	61 (62.9)	43 (79.6)	0.028
Refer from other hospitals	36 (37.1)	11 (20.4)
Season
Winter	40 (41.2)	18 (33.3)
Rainy	23 (23.71)	19 (35.1)	0.493
Summer	34 (35.05)	17 (31.5)
Clinical signs and symptoms
Prodomal infection	7 (7.1)	5 (9.1)	0.668
Fever	21 (21.4)	18 (32.7)	0.126
Pallor	7 (7.1)	9 (16.7)	0.081
Lethargy	24 (24.5)	17 (30.9)	0.391
Irritability or abdominal pain	85 (86.7)	44 (80)	0.275
Non-bilious vomiting	58 (59.2)	33 (60)	0.921
Bilious vomiting	7 (7.1)	6 (10.9)	0.426
Abnormal stool frequency /consistency	29 (29.9)	20 (34)	0.412
Bloody stool	35 (35.7)	14 (25.5)	0.194
Abdominal distension	39 (39.8)	20 (36.4)	0.676
Palpable mass at abdomen	24 (24.5)	0 (0)	0.001
Lethargy	24 (24.5)	17 (30.9)	0.391
Seizure	5 (5.1)	1 (1.8)	0.336

Data are presented as the mean (SD) or n (%).

Table 2 Diagnostic value of promising parameters and proposed scores to detect intussusception

Promising parameters and proposed models	Sensitivity	Specificity	PPV	NPV	Accuracy
AR	0.592	0.709	0.784	0.494	0.634
Male gender	0.633	0.382	0.646	0.368	0.542
Age 6 mo to 2 years	0.653	0.582	0.736	0.485	0.627
Vomiting	0.592	0.400	0.637	0.355	0.523
Bloody stool	0.357	0.745	0.714	0.394	0.497
Irritability or abdominal pain	0.867	0.200	0.659	0.458	0.627
Abdominal distension	0.398	0.636	0.661	0.372	0.484
Palpable abdominal mass	0.245	1	1	0.426	0.516
Fever	0.214	0.673	0.538	0.325	0.379
Lethargy	0.245	0.691	0.585	0.339	0.405
Age 6 mo to 2 years + irritability or abdominal pain	0.959	0.091	0.653	0.556	0.647
Age 6 mo to 2 years + irritability or abdominal pain + palpable abdominal mass	0.704	0.582	0.75	0.525	0.66
Age 6 mo to 2 years + irritability or abdominal pain + abdominal distension	0.959	0.091	0.653	0.556	0.647
Age 6 mo to 2 years + irritability or abdominal pain + vomiting	0.959	0.091	0.653	0.556	0.647
Model 1: AR + age 6 mo to 2 years + irritability or abdominal pain	0.857	0.455	0.737	0.641	0.712
Model 2: AR + age 6 mo to 2 years + irritability or abdominal pain + palpable abdominal mass	0.816	0.545	0.762	0.625	0.719
Model 3: AR + age 6 mo to 2 years + irritability or abdominal pain + abdominal distension	0.857	0.455	0.737	0.641	0.712
Model 4: AR + age 6 mo to 2 years + irritability or abdominal pain + vomiting	0.857	0.455	0.737	0.641	0.712

AR: Abdominal X-ray, PPV: Positive predictive value; NPV: Negative predictive value.

Table 3 Area under the receiver operating characteristic curve of the promising parameters and proposed models for children suspected of intussusception

Promising parameters and proposed models	AUC	95%CI		P value
AR	0.650	0.560	0.741	0.002a
Male gender	0.507	0.412	0.603	0.882
Age 6 mo to 2 years	0.617	0.524	0.711	0.016a
Vomiting	0.504	0.408	0.600	0.933
Bloody stool	0.551	0.457	0.645	0.293
Abdominal pain or irritability	0.534	0.437	0.630	0.490
Abdominal distension	0.517	0.422	0.613	0.725
Palpable abdominal mass	0.622	0.535	0.710	0.012a
Afebrile state	0.556	0.460	0.653	0.247
Lethargy	0.532	0.436	0.628	0.511
Model 1: AR + age 6 mo to 2 years + irritability or abdominal pain	0.704	0.616	0.792	< 0.001a
Model 2: AR + age 6 mo to 2 years + irritability or abdominal pain + palpable abdominal mass	0.763	0.688	0.839	< 0.001a
Model 3: AR + age 6 mo to 2 years + irritability or abdominal pain + abdominal distension	0.640	0.550	0.729	0.004a
Model 4: AR + age 6 mo to 2 years + irritability or abdominal pain + vomiting	0.701	0.613	0.790	< 0.001a

AR: Abdominal X-ray; CI: Conference interval; AUC: Area under the curve.

^aStatistical significance or P < 0.05.