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Validation and modification of the ‘Chiang Mai University Intussusception scoring system’ used to predict failure of non-surgical treatment in infantile intussusception
  1. Kaimook Boonsanit1,
  2. Supika Kritsaneepaiboon2,
  3. Piyawan Chiengkriwate1 and
  4. Surasak Sangkhathat1
  1. 1Department of Surgery, Prince of Songkla University, Faculty of Medicine, Hat Yai, Thailand
  2. 2Department of Radiology, Prince of Songkla University, Faculty of Medicine, Hat Yai, Thailand
  1. Correspondence to Dr Surasak Sangkhathat; surasak.sa{at}psu.ac.th

Abstract

Background This study aimed to validate and modify the recently released Chiang Mai University Intussusception (CMUI) scoring system in predicting failure of non-surgical management of infantile intussusception.

Methods A retrospective review was conducted in 151 cases of infantile intussusception who were primarily treated with pneumatic reduction in our institute during 2008–2018. The analysis focused on the validation of the CMUI scoring system. Following this analysis, the scoring system was modified to be more suitable for our clinical practice, in which we perform pneumatic reduction in all cases.

Results Pneumatic reduction was successfully performed in 120/151 cases (79.5%). A high CMUI score was significantly associated with increased likelihood of failure at the positive likelihood ratio of 1.49 (sensitivity 25.8 and specificity 82.7). The area under the receiver operating characteristic curve (AUC) was 0.73. We modified the CMUI System in two ways, first by removing the item ‘method of reduction’ and replacing it with ‘hyponatremia’, and by changing the definition of low body weight to less than 9 kg. The modified CMUI had an AUC of 0.76. A high score (>9 points) on the modified version gave a positive likelihood ratio of 4.77 (sensitivity 53.0 and specificity 80.9).

Conclusion In infantile intussusception primarily treated with pneumatic reduction, the modified CMUI scoring system gave a better prediction reliability than the original.

  • paediatric surgery
  • accident and emergency
  • gastroenterology

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors KB (first author and the principal investigator) pursued all data collection and analysis. SK pursued radiologic data collection and interpretation. PC pursued a part of clinical data collection and interpretation. SS (corresponding author) performed data analysis, and edited the proposal and final draft of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Human Research Ethics Committee of the Faculty of Medicine, Prince of Songkla University, Thailand.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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