EN
TÜRKÇE
Poster - 325
Optimizing management of intussusception in LMICs: is routine admission always necessary?
Zara Bhatti 1, Javeria Javed 1, Fatima Arshad 1, Muhammad Osama Khan 1, Humza Thobani 2, Muhammad Aqil Soomro 1, Saqib Qazi 1, Faraz Ali Khan 2, Saleem Islam 1
1 Section of Pediatric Surgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
2 Division of Pediatric Surgery, Department of Surgery, Stanford University, Palo Alto, California
Purpose
Intussusception is a leading cause of intestinal obstruction in children. It is standard practice to admit patients for observation after successful reduction in the emergency room (ER). In low- and middle-income countries (LMICs), healthcare is largely out-of-pocket and strategies that reduce unnecessary admissions without compromising safety are essential. This study compared the clinical outcomes and recurrence rates in children managed through routine inpatient admission versus those discharged from the ER.
Methods
We conducted a retrospective cohort study of children diagnosed with intussusception between 2010 and 2024 at a tertiary-care hospital. Demographic and clinical data were extracted from the medical records. The outcomes assessed were recurrence of intussusception and length of hospital stay.
Results
We included 189 patients in the study with 159 admitted for observation (Group A) and 30 discharged from the ER unless admission was clinically warranted (Group B). Patients in Group B were younger (median age: 0.9 vs. 2.0 years, p < 0.01) and presented with fewer severe clinical symptoms than those in Group A. Abdominal pain (78% vs. 33%) and blood in the stool (64% vs. 40%) were more common in Group A (p < 0.01, p = 0.01). Recurrence was slightly higher in Group B (13% vs. 8%), although the difference was not significant (p = 0.50). In the multivariable analysis, ER-based management was not associated with increased recurrence (adjusted OR: 0.56; 95% CI: 0.14–1.89; p = 0.40). A hospital stay <3 days was more frequent in Group B (83% vs. 73%, p = 0.02).
Conclusion
We found that ER-based management did not influence intussusception recurrence and was associated with shorter hospital stays. In LMICs, this approach may provide a safe and cost-effective alternative to routine admissions.