Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Center of Clinical Epidemiology and Clinical Statistic, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Int J Environ Res Public Health. 2022 Apr 26;19(9):5289. doi: 10.3390/ijerph19095289.
This study aimed to validate the "Chiang Mai University Intussusception Failed Score (CMUI)" for intussusception non-operative reduction. Both a 2-year retrospective and a 5-year prospective consecutive review of patients with intussusception were conducted. Data were collected from January 2013 to December 2020. Related retrospective data of a developmental set from two centers from January 2006 to December 2012 were used. Ten prespecified prognostic factors for failed reduction were collected and from these a predictive score was calculated. The actual results of non-operative reduction were collected and set as a reference standard. Altogether, 195 episodes of intussusception were found. Twenty-two patients were excluded due to contraindications; therefore, a total of 173 episodes were included in the validation dataset. The development data set comprised 170 episodes. We found that no statistical significance was found from comparing the areas under the ROC of two datasets (-value = 0.31), while specificity of the validation set was 93.8% (88.1-97.3). This temporal validation showed a high specificity and a high affinity for prediction of failed reduction as the development dataset despite being in an era of a higher successful reduction rate. The intensive reduction protocols might be introduced among patients with high-risk scores.
本研究旨在验证 Chiang Mai University Intussusception Failed Score（CMUI）在肠套叠非手术复位中的有效性。对 2013 年 1 月至 2020 年 12 月期间患有肠套叠的患者进行了为期 2 年的回顾性研究和 5 年的前瞻性连续回顾研究。收集了与发展数据集相关的回顾性数据，该数据集来自两个中心，时间为 2006 年 1 月至 2012 年 12 月。共收集了 10 个与失败复位相关的预后因素，并从这些因素中计算出预测评分。收集非手术复位的实际结果作为参考标准。总共发现了 195 例肠套叠。由于存在禁忌症，有 22 例患者被排除在外；因此，共有 173 例被纳入验证数据集。发展数据集包含 170 例。我们发现，比较两个数据集的 ROC 曲线下面积没有统计学意义（-值=0.31），而验证数据集的特异性为 93.8%（88.1-97.3）。尽管处于更高的成功复位率时代，但该时间验证显示出了高特异性和高预测失败复位的亲和力。高危评分患者可能会采用强化复位方案。
