Haemostatic Indexes For Predicting Intestinal Necrosis In Children With Intussusception

Background: To determine risk factors for intestinal necrosis in intussusception cases among children with failed non-surgical reduction for intussusception.Methods: Totally, 540 hospitalized individuals with unsuccessful air-enema reduction in our hospital between November 2010 and November 2020 were assessed in this retrospective study. The 540 intussusception cases were divided into the intestinal necrosis and non-intestinal necrosis groups. Haemostatic parameters, demographic and clinical features were assessed. Predictors of intestinal necrosis were examined by univariable and multivariable logistic regression analyses.Results: Of the 540 patients included, 113 showed intestinal necrosis. This intestinal necrosis group had a longer duration of symptom or length of illness, younger ages, higher platelet counts, fibrinogen amounts and D-dimer levels (all P = 0.000) compared with the nonintestinal necrosis group. Multivariable analysis revealed that duration of symptom (odds ratio (OR) 1.12; 95% confidence interval (CI) 1.16-1.23, P = 0.000), fibrinogen (OR 1.26; 95% CI 1.10-1.31, P = 0.010) and D-dimer (OR 2.07; 95% CI 1.91-2.28, P = 0.000) independently predicted intestinal necrosis in individuals undergoing surgical reduction for intussusception. Receiver operating characteristic curve analysis showed that D-dimer amounts had the largest area under the curve for predicting intestinal necrosis.Conclusion: On admission, long duration of symptom, high fibrinogen and D-dimer levels are critical risk factors for intestinal necrosis development in children with unsuccessful non-surgical reduction. D-Dimer levels have the best predictive value for intestinal necrosis.