Abstract
BackgroundThe epidemiology of intussusception, including its incidence, can vary between different countries. The aim of this study was to describe the epidemiology of childhood intussusception in Japan using data from a nationwide inpatient database.MethodsWe screened the database for eligible cases ≤ 18 years of age, who were coded with a discharge diagnosis of intussusception (International Classification of Diseases, 10th revision: K-561) between July to December in 2007 and 2008. We then selected cases according to Level 1 of the diagnostic certainty criteria developed by the Brighton Collaboration Intussusception Working Group. We examined the demographics, management, and outcomes of cases, and estimated the incidence of intussusception.ResultsWe identified 2,427 cases of intussusception. There were an estimated 2,000 cases of infantile intussusception annually in Japan, an incidence of 180-190 cases per 100,000 infants. The median age at diagnosis was 17 months, and two-thirds of the patients were male. Treatment with an enema was successful in 93.0% of cases (2255/2427). The remainder required surgery. Secondary cases accounted for 3.1% (76/2427). Median length of hospital stay was 3 days. Of the 2,427 cases, we found 2 fatal cases associated with intussusception.ConclusionsThis is currently the largest survey of childhood intussusception in Asia using a standardized case definition. Our results provide an estimate of the baseline risk of intussusception in Japan, and it is higher than the risk observed in other countries.
Highlights
The epidemiology of intussusception, including its incidence, can vary between different countries
The primary goal of our study was to describe the epidemiology of childhood intussusception in Japan, including patients’ demographic characteristics, management, and outcomes, and to estimate the baseline incidence of infantile intussusception before the introduction of the Rotavaccine program
Recent analyses of childhood intussusception in Western countries [1,18,19] found that the peak age was between 4 and 9 months; the male:female ratio was around 2:1; pathological lead points (PLPs) were found in 2.6-15% of cases; and non-surgical enema reductions were successful in 8095% of patients
Summary
The epidemiology of intussusception, including its incidence, can vary between different countries. In 1999, Rotashield (the first-generation rotavirus vaccine licensed in the United States) was withdrawn from the market because of a potential increased risk of intussusception [4]. Two recent studies investigated whether the second-generation Rotavirus vaccine was associated with an increased risk of intussusception [5,6], and revealed conflicting results. One post-marketing survey reported a small but statistically significant increased risk [5], while the other study found no evidence of an elevated risk of intussusception [6]. The results vary, ranging from 70 to 300 cases per 100,000 children, suggesting that there are regional differences in the incidence of intussusception
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