Cargando…

Pediatric Intussusception: Decreased Surgical Risk with Timely Transfer to a Children’s Hospital

INTRODUCTION: Intussusception is a potentially life-threatening condition, and a frequent cause of bowel obstruction during the first two years of life. We hypothesized that patients who were transferred from outside community hospitals, or OSH, without tertiary care capabilities for pediatric servi...

Descripción completa

Detalles Bibliográficos
Autores principales: Blackwood, Brian P, Theodorou, Christina M, Hebal, Ferdynand, Hunter M, Catherine J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472396/
https://www.ncbi.nlm.nih.gov/pubmed/28626836
http://dx.doi.org/10.21767/2471-805X.100018
_version_ 1783244113303306240
author Blackwood, Brian P
Theodorou, Christina M
Hebal, Ferdynand
Hunter M, Catherine J
author_facet Blackwood, Brian P
Theodorou, Christina M
Hebal, Ferdynand
Hunter M, Catherine J
author_sort Blackwood, Brian P
collection PubMed
description INTRODUCTION: Intussusception is a potentially life-threatening condition, and a frequent cause of bowel obstruction during the first two years of life. We hypothesized that patients who were transferred from outside community hospitals, or OSH, without tertiary care capabilities for pediatric services to a large academic children’s hospital with intussusception were more likely to require operative management for their intussusception than those who were directly admitted. METHODS: The electronic medical record was queried for patients presenting to Ann and Robert H. Lurie Children’s Hospital of Chicago with a diagnosis of intussusception (July 1(st), 2009–July 1(st), 2014). Age, sex, symptom duration, radiologic management, and surgical care were recorded. OSH and transfer reports were analyzed for those patients that presented as a transfer. Statistical analysis was performed. RESULTS: We identified 270 patients with intussusception. 232 (80%) were successfully treated non-surgically. 58 (20%) required surgical management. Of the patients requiring surgery, there were 38 reductions (24 laparoscopic, 14 open) and 20 bowel resections (1 laparoscopic, 19 open). Of those patients requiring surgery, 37 (63.8%) had presented as a transfer from an OSH. We found that transferred patients, requiring surgery, spent a mean 7.77 hours at the OSH compared to 4.03 hours for the transferred patients that did not require surgery (p=0.0188). There was no significant difference in transport time (p=0.44). CONCLUSION: In conclusion, we identified the amount of time patients spend at hospitals without pediatric surgical capabilities as an independent risk factor necessitating surgical management of intussusception. These data suggest that patients with intussusception who present to hospitals without pediatric radiology or pediatric surgery, should be transferred in an expedited fashion. In the event of a failed enema reduction at an OSH, the transport of the patient should not be delayed as this may result in a higher likelihood of surgical management.
format Online
Article
Text
id pubmed-5472396
institution National Center for Biotechnology Information
language English
publishDate 2016
record_format MEDLINE/PubMed
spelling pubmed-54723962017-06-15 Pediatric Intussusception: Decreased Surgical Risk with Timely Transfer to a Children’s Hospital Blackwood, Brian P Theodorou, Christina M Hebal, Ferdynand Hunter M, Catherine J Pediatr Care (Wilmington) Article INTRODUCTION: Intussusception is a potentially life-threatening condition, and a frequent cause of bowel obstruction during the first two years of life. We hypothesized that patients who were transferred from outside community hospitals, or OSH, without tertiary care capabilities for pediatric services to a large academic children’s hospital with intussusception were more likely to require operative management for their intussusception than those who were directly admitted. METHODS: The electronic medical record was queried for patients presenting to Ann and Robert H. Lurie Children’s Hospital of Chicago with a diagnosis of intussusception (July 1(st), 2009–July 1(st), 2014). Age, sex, symptom duration, radiologic management, and surgical care were recorded. OSH and transfer reports were analyzed for those patients that presented as a transfer. Statistical analysis was performed. RESULTS: We identified 270 patients with intussusception. 232 (80%) were successfully treated non-surgically. 58 (20%) required surgical management. Of the patients requiring surgery, there were 38 reductions (24 laparoscopic, 14 open) and 20 bowel resections (1 laparoscopic, 19 open). Of those patients requiring surgery, 37 (63.8%) had presented as a transfer from an OSH. We found that transferred patients, requiring surgery, spent a mean 7.77 hours at the OSH compared to 4.03 hours for the transferred patients that did not require surgery (p=0.0188). There was no significant difference in transport time (p=0.44). CONCLUSION: In conclusion, we identified the amount of time patients spend at hospitals without pediatric surgical capabilities as an independent risk factor necessitating surgical management of intussusception. These data suggest that patients with intussusception who present to hospitals without pediatric radiology or pediatric surgery, should be transferred in an expedited fashion. In the event of a failed enema reduction at an OSH, the transport of the patient should not be delayed as this may result in a higher likelihood of surgical management. 2016-10-08 2016 /pmc/articles/PMC5472396/ /pubmed/28626836 http://dx.doi.org/10.21767/2471-805X.100018 Text en http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Article
Blackwood, Brian P
Theodorou, Christina M
Hebal, Ferdynand
Hunter M, Catherine J
Pediatric Intussusception: Decreased Surgical Risk with Timely Transfer to a Children’s Hospital
title Pediatric Intussusception: Decreased Surgical Risk with Timely Transfer to a Children’s Hospital
title_full Pediatric Intussusception: Decreased Surgical Risk with Timely Transfer to a Children’s Hospital
title_fullStr Pediatric Intussusception: Decreased Surgical Risk with Timely Transfer to a Children’s Hospital
title_full_unstemmed Pediatric Intussusception: Decreased Surgical Risk with Timely Transfer to a Children’s Hospital
title_short Pediatric Intussusception: Decreased Surgical Risk with Timely Transfer to a Children’s Hospital
title_sort pediatric intussusception: decreased surgical risk with timely transfer to a children’s hospital
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472396/
https://www.ncbi.nlm.nih.gov/pubmed/28626836
http://dx.doi.org/10.21767/2471-805X.100018
work_keys_str_mv AT blackwoodbrianp pediatricintussusceptiondecreasedsurgicalriskwithtimelytransfertoachildrenshospital
AT theodorouchristinam pediatricintussusceptiondecreasedsurgicalriskwithtimelytransfertoachildrenshospital
AT hebalferdynand pediatricintussusceptiondecreasedsurgicalriskwithtimelytransfertoachildrenshospital
AT huntermcatherinej pediatricintussusceptiondecreasedsurgicalriskwithtimelytransfertoachildrenshospital