Wang Guangyu, Li Zhongce, Duan Guangqi, Sui Bangzhi, Jin Zhiyuan, Chu Zhenjie, Tang Rui, Wang Xiao, Ma Honglong, Qi Shiqin, Liu Jie
Department of Pediatric Surgery, Yijishan Hospital of Wannan Medical College, Wannan Medical College, Wuhu, China.
Department of General Surgery, Anhui Children's Hospital, Hefei, China.
Front Pediatr. 2025 Jul 9;13:1571203. doi: 10.3389/fped.2025.1571203. eCollection 2025.
This study aimed to develop a nomogram to predict the probability of spontaneous reduction of intussusception (SROI) in pediatric patients.
Clinical data of children diagnosed with intussusception and admitted to two hospitals in China from May 2023 to December 2024 were retrospectively analyzed. The eligible patients were randomly divided into the training and validation cohorts in a 7:3 ratio. The least absolute shrinkage and selection operator (LASSO) and multivariable logistic regression analyses were employed to identify essential variables for the development of the nomogram. The nomogram's performance was evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).
A total of 290 cases were included, of whom 114 patients underwent spontaneous reduction. The study identified six predictors of SROI: age, presence of bloody stool (bleed), comorbidities, mode of birth (MOB), intussusception region (right, left, and mid-abdomen), and length. The results demonstrate that older age and short-segment intussusception are significantly associated with an enhanced possibility of SROI. The nomogram demonstrated high discriminatory power with an area under the ROC curve (AUC) of 0.922 in the training cohort and 0.932 in the validation cohort. Calibration curves showed good agreement between predicted and observed outcomes. DCA indicated that the nomogram provided substantial net benefits for clinical application.
The developed nomogram is a reliable and precise tool for predicting the likelihood of SROI in pediatric patients. It can assist clinicians in making treatment decisions, potentially reducing unnecessary invasive interventions and optimizing healthcare resource utilization.
本研究旨在开发一种列线图，以预测儿科患者肠套叠自发复位（SROI）的概率。
回顾性分析2023年5月至2024年12月在中国两家医院确诊为肠套叠并入院的儿童的临床资料。符合条件的患者按7:3的比例随机分为训练组和验证组。采用最小绝对收缩和选择算子（LASSO）和多变量逻辑回归分析来确定列线图开发的关键变量。使用受试者工作特征（ROC）曲线、校准曲线和决策曲线分析（DCA）对列线图的性能进行评估。
共纳入290例病例，其中114例患者实现了自发复位。该研究确定了SROI的六个预测因素：年龄、血便（bleed）、合并症、分娩方式（MOB）、肠套叠部位（右侧、左侧和中腹部）以及长度。结果表明，年龄较大和短段肠套叠与SROI可能性增加显著相关。列线图在训练组中的ROC曲线下面积（AUC）为0.922，在验证组中为0.932，显示出较高的辨别力。校准曲线显示预测结果与观察结果之间具有良好的一致性。DCA表明，列线图在临床应用中提供了显著的净效益。
所开发的列线图是预测儿科患者SROI可能性的可靠且精确的工具。它可以帮助临床医生做出治疗决策，潜在地减少不必要的侵入性干预并优化医疗资源利用。
