Risk factors for recurrent intussusception in children: a retrospective cohort study

OBJECTIVE The aim of this study was to assess the frequency of clinical features and pathological lead points in recurrent intussusception, with a special focus on the risk factors that lead to recurrent intussusception. DESIGN This is a retrospective cohort study. A 5-year retrospective study was performed between January 2012 and July 2016 in the Children's Hospital of Soochow University, Suzhou, China, to determine the clinical features and pathological lead points of recurrent intussusception. SETTING This is a retrospective chart review of recurrent intussusception cases in a large university teaching hospital. PARTICIPANTS The medical records were obtained for 1007 cases with intussusception, including demographics, clinical signs and symptoms, imaging and recurrence times if available. INTERVENTIONS Univariate and multivariate logistic regression analyses were used to measure significant factors affecting recurrent intussusception and recurrent intussusception with pathological lead points. RESULTS There were 481 total episodes of recurrence in 191 patients. Among these, 87 had one recurrence and 104 had multiple recurrences. After comparing recurrent and non-recurrent intussusception cases using univariate analysis, it was determined that the factors associated with recurrent intussusception were age (>1 year), duration of symptoms (≤12 hours), the lack of bloody stool, paroxysmal crying or vomiting, the mass location (right abdomen) and pathological lead point (P<0.05). Age (>1 year), duration of symptoms (≤12 hours), the absence of vomiting, mass location (right abdomen) and pathological lead point were significantly independently predictive of recurrent intussusception. The factors associated with recurrent intussusception with lead points present were vomiting and mass location in the right abdomen (P<0.05). Vomiting and mass location (left abdomen) were significantly predictive of recurrent intussusception with lead points. CONCLUSIONS Age (>1 year), symptom duration (≤12 hours), the absence of vomiting, mass location (right abdomen) and pathological lead points were significantly predictive of recurrent intussusception. Vomiting and mass location (left abdomen) were significantly predictive of recurrent intussusception with lead points.