Predictors of intussusception in young children

Objective: To identify predictors of intussusception in young children. Design: A retrospective cross-sectional study. Setting and Patients: A consecutive sample of children younger than 5 years on whom contrast enemas were performed because of suspected intussusceptio n seen at an urban children's hospital from 1990 to 1995. Methods: We evaluated historical, clinical, and radiographic variables. Var iables documented in 75% or more of the medical records and associated with intussusception (P less than or equal to.20) in the univariate analysis we re evaluated in a multiple logistic regression analysis. Variables retainin g significance (P less than or equal to.05) in the multivariate analysis we re considered independent predictors of intussusception. We used bootstrap resampling techniques to validate the multivariate model. Results: Sixty-eight (59%) of the 115 patients had intussusception. Univari ate predictors of intussusception included male sea, age younger than 2 yea rs, history of emesis, rectal bleeding, lethargy, abdominal mass, and a hig hly suggestive abdominal radiograph. In the multivariate analysis, we ident ified only 4 independent predictors (adjusted odds ratio; 95% confidence in terval): a highly suggestive abdominal radiograph (18.3; 4.0-83.1), rectal bleeding (17.3; 2.9-104.0), male sex (6.2; 1.2-32.3), and a history of emes is (13.4; 1.4-126.0). We identified 3 of these 4 variables (all but emesis) as independent predictors in more than 50% of 1000 bootstrap data samples. Conclusions: Rectal bleeding, a highly suggestive abdominal radiograph, and male sea are variables independently associated with intussusception in a cohort of children suspected of having this diagnosis. Knowledge of these v ariables may assist in clinical decision making regarding diagnostic and th erapeutic interventions.