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Background <p>Acute intussusception is a common abdominal emergency in children. Although air enema reduction is an established effective treatment, the use of intravenous phloroglucinol alone for this condition has rarely been reported. This study aimed to evaluate the efficacy of phloroglucinol compared with air enema for pediatric acute intussusception and to develop and validate a predictive model for phloroglucinol treatment failure, aiding clinicians in early identification of high-risk children for timely management adjustment and prevention of severe complications.</p> Methods <p>We retrospectively analyzed clinical data from 1149 children with acute intussusception admitted to our hospital between January 2014 and December 2023. Baseline characteristics, clinical presentations, and ultrasound findings were collected. We used chi-square test to compare treatment outcomes between the phloroglucinol group (<i>n</i> = 757) and the air enema group (<i>n</i> = 392). Children in the phloroglucinol group were randomly divided into training and validation sets at a 7:3 ratio. Independent risk factors for phloroglucinol treatment failure were identified using univariate and multivariate logistic regression analyses, and a predictive model was constructed accordingly. Model performance was assessed using receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).</p> Results <p>(1) No statistically significant difference was observed in treatment success rates between the phloroglucinol and air enema groups (93.7% vs. 95.4%, <i>P</i> = 0.227). (2) Multivariate logistic regression analysis identified duration of symptoms, vomiting, and intussusception depth as independent risk factors for phloroglucinol treatment failure (all <i>P</i> &lt; 0.05). A nomogram incorporating these factors achieved an area under the ROC curve (AUC) of 0.96 (95%CI: 0.94–0.99) in the training set and 0.93 (95%CI: 0.81-1.00) in the validation set. Calibration curves demonstrated excellent agreement between predicted probabilities and observed outcomes. DCA indicated a significant clinical net benefit of the model.</p> Conclusion <p>Phloroglucinol appears to be an effective treatment option for pediatric acute intussusception. The developed nomogram, based on duration of symptoms, vomiting, and intussusception depth, exhibits robust predictive performance and may serve as a convenient and reliable tool for the early identification of children at high risk for phloroglucinol treatment failure, facilitating timely clinical decision-making.</p>

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Efficacy of phloroglucinol in pediatric acute intussusception and development of a predictive model for treatment failure: a retrospective cohort study

  • 期刊论文

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  • 发表日期：

    2026年7月21日

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  • Qi Zhou,
  • Xiangfen Ji,
  • Chao Liu,
  • Xiang Li,
  • Lei Zhang,
  • Yan Li

摘要

Background

Acute intussusception is a common abdominal emergency in children. Although air enema reduction is an established effective treatment, the use of intravenous phloroglucinol alone for this condition has rarely been reported. This study aimed to evaluate the efficacy of phloroglucinol compared with air enema for pediatric acute intussusception and to develop and validate a predictive model for phloroglucinol treatment failure, aiding clinicians in early identification of high-risk children for timely management adjustment and prevention of severe complications.

Methods

We retrospectively analyzed clinical data from 1149 children with acute intussusception admitted to our hospital between January 2014 and December 2023. Baseline characteristics, clinical presentations, and ultrasound findings were collected. We used chi-square test to compare treatment outcomes between the phloroglucinol group (n = 757) and the air enema group (n = 392). Children in the phloroglucinol group were randomly divided into training and validation sets at a 7:3 ratio. Independent risk factors for phloroglucinol treatment failure were identified using univariate and multivariate logistic regression analyses, and a predictive model was constructed accordingly. Model performance was assessed using receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).

Results

(1) No statistically significant difference was observed in treatment success rates between the phloroglucinol and air enema groups (93.7% vs. 95.4%, P = 0.227). (2) Multivariate logistic regression analysis identified duration of symptoms, vomiting, and intussusception depth as independent risk factors for phloroglucinol treatment failure (all P < 0.05). A nomogram incorporating these factors achieved an area under the ROC curve (AUC) of 0.96 (95%CI: 0.94–0.99) in the training set and 0.93 (95%CI: 0.81-1.00) in the validation set. Calibration curves demonstrated excellent agreement between predicted probabilities and observed outcomes. DCA indicated a significant clinical net benefit of the model.

Conclusion

Phloroglucinol appears to be an effective treatment option for pediatric acute intussusception. The developed nomogram, based on duration of symptoms, vomiting, and intussusception depth, exhibits robust predictive performance and may serve as a convenient and reliable tool for the early identification of children at high risk for phloroglucinol treatment failure, facilitating timely clinical decision-making.