Gunadi, Gunadi and Luzman, Raedi Ardlo and Kencana, Sagita Mega Sekar and Arthana, Bhagas Dwi and Ahmad, Fauzan and Sulaksmono, Ganjar and Rastaputra, Agitha Swandaru and Arini, Golda Puspa and Pitaka, Ririd Tri and Dwihantoro, Andi and Makhmudi, Akhmad (2021) Comparison of Two Different Cut-Off Values of Scoring System for Diagnosis of Hirschsprung-Associated Enterocolitis After Transanal Endorectal Pull-Through. Frontiers in Pediatrics, 9. ISSN 22962360
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Background: Hirschsprung-associated enterocolitis (HAEC) is a major contributor in the mortality of Hirschsprung disease (HSCR) patients that can occur both preoperatively and post-operatively. Several cut-off values of HAEC score have been used, i.e., ≥10 and ≥4. Here, we compared the HAEC frequency after transanal endorectal pull-through (TEPT) using two cut-offs of scoring system and associated them with the risk factors. Methods: Cross-sectional analysis was conducted using medical records of HSCR patients who were aged ≤18 years old and underwent TEPT at our institution, Indonesia between 2009 and 2016. HAEC was determined using the scoring system with cut-off values of ≥10 and ≥4. Results: Seventy subjects were used in the final analysis, consisting of 44 males and 26 females. There was a significant difference in one HAEC finding between the ≥10 and ≥4 cut-off groups; diarrhea with explosive stools (p = 0.002). The HAEC frequency was 5/70 (7.1) and 49/70 (70) patients using cut-off values of ≥10 and ≥4 (p < 0.0001), respectively. We found that patients with anemia (i.e., iron deficiency anemia) had a higher risk of HAEC after TEPT than patients with normal hemoglobin level with OR of 3.77 (95 CI = 1.28–11.1; p = 0.027), while no associations were found between other variables, including sex, age at diagnosis, age at definitive therapy, albumin level, and nutritional status and HAEC following TEPT (p = 0.87, 0.15, 0.33, 0.26, and 0.60, respectively). Also, no associations were observed between maternal education level, mother's age at pregnancy and gestational age and HAEC after definitive surgery (p = 0.10, 0.46, and 0.86, respectively). Conclusions: This report is the first study comparing two different cut-off values of scoring system to evaluate the HAEC frequency after TEPT and results suggest further using cut-off of ≥4 to expand the diagnosis of HAEC. Moreover, we also show for the first time that hemoglobin level is a strong risk factor for the HAEC development after TEPT. © Copyright © 2021 Gunadi, Luzman, Kencana, Arthana, Ahmad, Sulaksmono, Rastaputra, Arini, Pitaka, Dwihantoro and Makhmudi.
Item Type: | Article |
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Additional Information: | Cited by: 4; All Open Access, Gold Open Access, Green Open Access |
Uncontrolled Keywords: | albumin; hemoglobin; adult; albumin level; anemia; Article; controlled study; cross-sectional study; developing country; diagnostic test accuracy study; diagnostic value; diarrhea; disease association; educational status; enterocolitis; female; follow up; gestational age; hemoglobin blood level; Hirschsprung disease; human; Indonesia; intermethod comparison; major clinical study; male; maternal age; medical record review; nutritional status; pregnancy; preoperative evaluation; pull through operation; rectum hemorrhage; retrospective study; risk factor; scoring system; underweight |
Subjects: | R Medicine > RJ Pediatrics |
Divisions: | Faculty of Medicine, Public Health and Nursing > Biomedical Sciences |
Depositing User: | Sri JUNANDI |
Date Deposited: | 27 Sep 2024 02:06 |
Last Modified: | 27 Sep 2024 02:06 |
URI: | https://ir.lib.ugm.ac.id/id/eprint/4576 |