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Postoperative enterocolitis assessment using two different cut-off values in the HAEC score in Hirschsprung patients undergoing Duhamel and Soave pull-through

BACKGROUND: Hirschsprung-associated enterocolitis (HAEC) is the most severe and potentially lethal complication of Hirschsprung disease (HSCR) which might occur following definitive surgery. Our objectives were: 1) to compare the incidence of HAEC after Duhamel and Soave procedures using different c...

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Autores principales: Gunadi, Sukarelawanto, Afnandito Valeno Risky, Ritana, Azmi, Balela, Naisya, Putri, Wayan Julita Krisnanti, Sirait, Dian Nirmala, Paramita, Vincentia Meta Widya, Sasmita, Andika Purba, Dwihantoro, Andi, Makhmudi, Akhmad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7531158/
https://www.ncbi.nlm.nih.gov/pubmed/33008355
http://dx.doi.org/10.1186/s12887-020-02360-x
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author Gunadi
Sukarelawanto, Afnandito Valeno Risky
Ritana, Azmi
Balela, Naisya
Putri, Wayan Julita Krisnanti
Sirait, Dian Nirmala
Paramita, Vincentia Meta Widya
Sasmita, Andika Purba
Dwihantoro, Andi
Makhmudi, Akhmad
author_facet Gunadi
Sukarelawanto, Afnandito Valeno Risky
Ritana, Azmi
Balela, Naisya
Putri, Wayan Julita Krisnanti
Sirait, Dian Nirmala
Paramita, Vincentia Meta Widya
Sasmita, Andika Purba
Dwihantoro, Andi
Makhmudi, Akhmad
author_sort Gunadi
collection PubMed
description BACKGROUND: Hirschsprung-associated enterocolitis (HAEC) is the most severe and potentially lethal complication of Hirschsprung disease (HSCR) which might occur following definitive surgery. Our objectives were: 1) to compare the incidence of HAEC after Duhamel and Soave procedures using different cut-off values of the HAEC scoring method; and 2) to associate them with the risk factors, including sex, aganglionosis type, mothers’ age at childbirth, gestational age, and mothers’ educational level. METHODS: Medical records of patients with HSCR who underwent Soave and Duhamel procedures in our institution, Indonesia (January 2012 – December 2016) were reviewed retrospectively. Two cut-off values of the HAEC scoring system (i.e., ≥10 and ≥ 4) were utilized. RESULTS: Eighty-three patients with HSCR were recruited in this study (Soave: 37 males and 7 females vs. Duhamel: 28 males and 11 females; p = 0.18). The incidence of HAEC after surgery was 14/83 (16.9%) and 38/83 (45.8%) for cut-off values of ≥10 and ≥ 4, respectively (p = 0.00012), and tended to have an association with sex (p = 0.09). Although it was not statistically significant (p = 0.07), the frequency of HAEC after Soave procedure tended to be higher in patients with their mother’s age of ≤35 years at childbirth than those with their mother’s age of > 35 years (OR = 7.9; 95% CI = 0.9–72.1). Multivariate analysis indicated none of the risk factors were associated with the frequency of HAEC after definitive surgery. CONCLUSIONS: The lower cut-off value of ≥4 might increase the possibility to diagnose HAEC, particularly the mild cases. The incidence of HAEC after definitive surgery was not associated with any risk factors in our cohort patients. Further multicenter studies with a larger sample size are necessary to confirm our findings.
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spelling pubmed-75311582020-10-05 Postoperative enterocolitis assessment using two different cut-off values in the HAEC score in Hirschsprung patients undergoing Duhamel and Soave pull-through Gunadi Sukarelawanto, Afnandito Valeno Risky Ritana, Azmi Balela, Naisya Putri, Wayan Julita Krisnanti Sirait, Dian Nirmala Paramita, Vincentia Meta Widya Sasmita, Andika Purba Dwihantoro, Andi Makhmudi, Akhmad BMC Pediatr Research Article BACKGROUND: Hirschsprung-associated enterocolitis (HAEC) is the most severe and potentially lethal complication of Hirschsprung disease (HSCR) which might occur following definitive surgery. Our objectives were: 1) to compare the incidence of HAEC after Duhamel and Soave procedures using different cut-off values of the HAEC scoring method; and 2) to associate them with the risk factors, including sex, aganglionosis type, mothers’ age at childbirth, gestational age, and mothers’ educational level. METHODS: Medical records of patients with HSCR who underwent Soave and Duhamel procedures in our institution, Indonesia (January 2012 – December 2016) were reviewed retrospectively. Two cut-off values of the HAEC scoring system (i.e., ≥10 and ≥ 4) were utilized. RESULTS: Eighty-three patients with HSCR were recruited in this study (Soave: 37 males and 7 females vs. Duhamel: 28 males and 11 females; p = 0.18). The incidence of HAEC after surgery was 14/83 (16.9%) and 38/83 (45.8%) for cut-off values of ≥10 and ≥ 4, respectively (p = 0.00012), and tended to have an association with sex (p = 0.09). Although it was not statistically significant (p = 0.07), the frequency of HAEC after Soave procedure tended to be higher in patients with their mother’s age of ≤35 years at childbirth than those with their mother’s age of > 35 years (OR = 7.9; 95% CI = 0.9–72.1). Multivariate analysis indicated none of the risk factors were associated with the frequency of HAEC after definitive surgery. CONCLUSIONS: The lower cut-off value of ≥4 might increase the possibility to diagnose HAEC, particularly the mild cases. The incidence of HAEC after definitive surgery was not associated with any risk factors in our cohort patients. Further multicenter studies with a larger sample size are necessary to confirm our findings. BioMed Central 2020-10-02 /pmc/articles/PMC7531158/ /pubmed/33008355 http://dx.doi.org/10.1186/s12887-020-02360-x Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Gunadi
Sukarelawanto, Afnandito Valeno Risky
Ritana, Azmi
Balela, Naisya
Putri, Wayan Julita Krisnanti
Sirait, Dian Nirmala
Paramita, Vincentia Meta Widya
Sasmita, Andika Purba
Dwihantoro, Andi
Makhmudi, Akhmad
Postoperative enterocolitis assessment using two different cut-off values in the HAEC score in Hirschsprung patients undergoing Duhamel and Soave pull-through
title Postoperative enterocolitis assessment using two different cut-off values in the HAEC score in Hirschsprung patients undergoing Duhamel and Soave pull-through
title_full Postoperative enterocolitis assessment using two different cut-off values in the HAEC score in Hirschsprung patients undergoing Duhamel and Soave pull-through
title_fullStr Postoperative enterocolitis assessment using two different cut-off values in the HAEC score in Hirschsprung patients undergoing Duhamel and Soave pull-through
title_full_unstemmed Postoperative enterocolitis assessment using two different cut-off values in the HAEC score in Hirschsprung patients undergoing Duhamel and Soave pull-through
title_short Postoperative enterocolitis assessment using two different cut-off values in the HAEC score in Hirschsprung patients undergoing Duhamel and Soave pull-through
title_sort postoperative enterocolitis assessment using two different cut-off values in the haec score in hirschsprung patients undergoing duhamel and soave pull-through
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7531158/
https://www.ncbi.nlm.nih.gov/pubmed/33008355
http://dx.doi.org/10.1186/s12887-020-02360-x
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