Critical evaluation of the Hirschsprung-associated enterocolitis (HAEC) score: A multicenter study of 116 children with Hirschsprung disease
| Autor: | Akemi L. Kawaguchi, Thomas T. Hui, Philip K. Frykman, Tomas Wester, Andre Rogatko, Daniel H. Teitelbaum, Sungjin Kim, Agneta Nordenskjöld, Anna Löf Granström |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Hirschsprung associated enterocolitis Pediatrics medicine.medical_specialty Adolescent Disease Logistic regression Sensitivity and Specificity Article 03 medical and health sciences 0302 clinical medicine 030225 pediatrics medicine Humans Hirschsprung Disease Child Retrospective Studies Enterocolitis Framingham Risk Score business.industry Medical record Infant Newborn Infant General Medicine Logistic Models Multicenter study Child Preschool Pediatrics Perinatology and Child Health cardiovascular system 030211 gastroenterology & hepatology Surgery Female medicine.symptom business Complication |
| Zdroj: | Journal of pediatric surgery. 53(4) |
| ISSN: | 1531-5037 |
| Popis: | Objective To identify the optimal clinical criteria to diagnose Hirschsprung-associated enterocolitis (HAEC) in children with Hirschsprung disease (HSCR). Background HAEC is the most common life-threatening complication in HSCR patients, yet the diagnostic criteria for HAEC remain unclear. The consensus-based HAEC scoring system was not validated using patient data, thereby making its diagnostic accuracy uncertain. Methods From 2009 to 2015, consecutive children with HSCR underwent retrospective evaluation of their medical records, and questionnaire-directed parent interviews to identify treatment of suspected HAEC episodes and the 16 clinical criteria in the HAEC score. Logistic regression modeling was employed to identify criteria predicting suspected HAEC episodes. Results One hundred sixteen HSCR patients met inclusion criteria, 43 patients (37.1%) were treated for at least one suspected HAEC episode. An HAEC score of 4 maximized the sum of sensitivity (83.7%) and specificity (98.6%) while the previously established cut-off score of 10 showed lower sensitivity (41.9%) with perfect specificity. Multivariable analysis identified four criteria utilized to create a new HAEC Risk score with performance characteristics similar to the HAEC score cutoff of 4. Conclusion When using the HAEC score, a cutoff of 4 should be used rather than 10, which under-diagnosed patients with HAEC. Alternatively, the new HAEC Risk score could be employed. Level of Evidence Diagnostic Study, Level 3. |
| Databáze: | OpenAIRE |
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