is the most common cause of intestinal obstruction in infants and children. To date, no study has evaluated the ability of physicians to predict the likelihood
This study aimed to determine the ability of pediatric physicians to predict intussusception
in patients being evaluated for intussusception
and to investigate whether certain clinical findings correlate with physicians’ risk assessment.
A prospective cohort study of children aged 1 month to 6 years who presented with possible intussusception
. The predicted likelihood
was recorded by physicians before knowledge of imaging results or final diagnosis. We defined a physician’s prediction as high versus low risk based on a threshold prediction of 25% likelihood
A total of 308 patients were studied including 38 (12.3%) with intussusception
. Physicians’ prediction was positively associated with the risk of intussusception
(test for linear trend: odds ratio [OR], 2.1; 95% confidence interval [CI], 1.6–2.7; P
< 0.001). Among patients considered high risk, the rate of intussusception
was 36% (95% CI, 25%–49%) compared with 6% for those judged to be low risk (95% CI, 4%–10%). Using a threshold of 25% likelihood
, successful prediction of high versus low risk occurred in 82% (95% CI, 77%–86%). Clinical predictors associated with assigning a designation of higher risk of intussusception
included lethargy at home (OR, 2.7; 95% CI, 1.4–5.5) and bloody stool (OR, 2.5; 95% CI, 1.0–5.9).
Pediatric physicians can accurately predict the likelihood
. This ability to properly judge the risk of intussusception
can be incorporated into management strategies.