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Development of Clinical Referral Score Model for Early Diagnosis of Hirschsprung’s Disease in Suspected Pediatric Patients

The diagnosis of Hirschsprung’s disease (HSCR) relies on history, physical examination, and investigations. Some of investigation modalities could not be done in primary hospital. This study was aimed to develop the clinical score model for diagnosing and early referrals of HSCR, especially in areas...

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Autores principales: Khorana, Jiraporn, Phiromkanchanasak, Phawinee, Kumsattra, Jitthiwimon, Klinoun, Suparada, Aksorn, Suthasinee, Chantakhow, Sireekarn, Tepmalai, Kanokkan, Singhavejsakul, Jesda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8229157/
https://www.ncbi.nlm.nih.gov/pubmed/34200020
http://dx.doi.org/10.3390/healthcare9060678
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author Khorana, Jiraporn
Phiromkanchanasak, Phawinee
Kumsattra, Jitthiwimon
Klinoun, Suparada
Aksorn, Suthasinee
Chantakhow, Sireekarn
Tepmalai, Kanokkan
Singhavejsakul, Jesda
author_facet Khorana, Jiraporn
Phiromkanchanasak, Phawinee
Kumsattra, Jitthiwimon
Klinoun, Suparada
Aksorn, Suthasinee
Chantakhow, Sireekarn
Tepmalai, Kanokkan
Singhavejsakul, Jesda
author_sort Khorana, Jiraporn
collection PubMed
description The diagnosis of Hirschsprung’s disease (HSCR) relies on history, physical examination, and investigations. Some of investigation modalities could not be done in primary hospital. This study was aimed to develop the clinical score model for diagnosing and early referrals of HSCR, especially in areas where investigations were not available. Overall 483 consecutive suspected HSCR patients who were under 15 years old from January 2006 to December 2020 were included in this study, with 207 (42.86%) patients diagnosed with HSCR and 276 (51.14%) patients in the non-HSCR group. Five clinical parameters were included in the prediction model. The AuROC of clinical parameters, which included having an age younger than one month, male gender, the term infant, history of delayed meconium passage, and history of enterocolitis, was 72%. The prediction score ranged from 0–7, with a score 0–3 meaning a low risk to be HSCR (LHR+ = 0.37). We concluded that patients with suspected HSCR who had clinical score 4–7 had a high probability to be HSCR and, thus, it was suggested that these patients have an early referral for further investigations, which were contrast enema and rectal suction biopsy. In the case of a low probability of HSCR, clinical observation is still warranted. This clinical scoring system can be used as a screening tool to prevent delay diagnosis and complications.
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spelling pubmed-82291572021-06-26 Development of Clinical Referral Score Model for Early Diagnosis of Hirschsprung’s Disease in Suspected Pediatric Patients Khorana, Jiraporn Phiromkanchanasak, Phawinee Kumsattra, Jitthiwimon Klinoun, Suparada Aksorn, Suthasinee Chantakhow, Sireekarn Tepmalai, Kanokkan Singhavejsakul, Jesda Healthcare (Basel) Article The diagnosis of Hirschsprung’s disease (HSCR) relies on history, physical examination, and investigations. Some of investigation modalities could not be done in primary hospital. This study was aimed to develop the clinical score model for diagnosing and early referrals of HSCR, especially in areas where investigations were not available. Overall 483 consecutive suspected HSCR patients who were under 15 years old from January 2006 to December 2020 were included in this study, with 207 (42.86%) patients diagnosed with HSCR and 276 (51.14%) patients in the non-HSCR group. Five clinical parameters were included in the prediction model. The AuROC of clinical parameters, which included having an age younger than one month, male gender, the term infant, history of delayed meconium passage, and history of enterocolitis, was 72%. The prediction score ranged from 0–7, with a score 0–3 meaning a low risk to be HSCR (LHR+ = 0.37). We concluded that patients with suspected HSCR who had clinical score 4–7 had a high probability to be HSCR and, thus, it was suggested that these patients have an early referral for further investigations, which were contrast enema and rectal suction biopsy. In the case of a low probability of HSCR, clinical observation is still warranted. This clinical scoring system can be used as a screening tool to prevent delay diagnosis and complications. MDPI 2021-06-04 /pmc/articles/PMC8229157/ /pubmed/34200020 http://dx.doi.org/10.3390/healthcare9060678 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Khorana, Jiraporn
Phiromkanchanasak, Phawinee
Kumsattra, Jitthiwimon
Klinoun, Suparada
Aksorn, Suthasinee
Chantakhow, Sireekarn
Tepmalai, Kanokkan
Singhavejsakul, Jesda
Development of Clinical Referral Score Model for Early Diagnosis of Hirschsprung’s Disease in Suspected Pediatric Patients
title Development of Clinical Referral Score Model for Early Diagnosis of Hirschsprung’s Disease in Suspected Pediatric Patients
title_full Development of Clinical Referral Score Model for Early Diagnosis of Hirschsprung’s Disease in Suspected Pediatric Patients
title_fullStr Development of Clinical Referral Score Model for Early Diagnosis of Hirschsprung’s Disease in Suspected Pediatric Patients
title_full_unstemmed Development of Clinical Referral Score Model for Early Diagnosis of Hirschsprung’s Disease in Suspected Pediatric Patients
title_short Development of Clinical Referral Score Model for Early Diagnosis of Hirschsprung’s Disease in Suspected Pediatric Patients
title_sort development of clinical referral score model for early diagnosis of hirschsprung’s disease in suspected pediatric patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8229157/
https://www.ncbi.nlm.nih.gov/pubmed/34200020
http://dx.doi.org/10.3390/healthcare9060678
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