Impact of overweight/obesity on clinical outcomes after reduction for intussusception in children

Purpose Childhood obesity is a worsening epidemic. Little is known about the impact of overweight and obesity (OV–OB) on clinical outcomes after reduction for intussusception in children. The aim of this study was to compare clinical outcomes after primarily air enema reduction for intussusception in grouped OV–OB (body mass index-for-age percentile ≥ 85) pediatric patients compared with no OV–OB patients. Methods A retrospective study of 564 children who had undergone intussusception reduction via pneumatic reduction (PR) from April 2018 to January 2020 was conducted with assessments of demographic data, clinical symptoms, pre-reduction examination, and reduction results. One-to-one propensity score matching (PSM) was performed to compare clinical outcomes between patients with and without OV–OB, and the risk factors affecting recurrence and surgical reduction were analyzed in the PSM population. Results Of the 564 patients, 132 cases (23.4%) were OV–OB (overweight: 95 cases; obesity: 37 cases). In the propensity-matched analysis, the OV–OB group showed a significant increase in surgical reduction (10.2% versus 0.9%, P = 0.005) and recurrence (47.2% versus 10.2%, P < 0.001), excretion time of carbon powder after PR (median: 11.2 h versus 8.4 h, P < 0.001), higher maximum pressure of PR (median: 10.2 kPa versus 7.8 kPa, P < 0.001), and number of PR attempts (mean: 2.0 versus 1.4, P < 0.001). There were no significant differences in the reasons for surgery (PR failure or bowel perforation), time to recurrence (early or late), and the times of recurrences ≥ 2. After applying the multivariate logistic regression analysis, we found that OV–OB and white blood cell count ≥ 20 × 10 9 /L were risk factors for both surgical reduction and the recurrence of intussusception. Conclusion This study suggested that childhood OV–OB was associated with the failure of PR and recurrence of intussusception after reduction, which should be paid more attention in clinical practice.