ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Surgery
Volume 13 - 2025 | doi: 10.3389/fped.2025.1660827
Establishment and validation of a nomogram to predict thirty-day unplanned reoperations of primary anastomosis in neonates with intestinal atresias
Provisionally accepted
- Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
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Background/Purpose Unplanned reoperation rates becoming a critical metric for evaluating healthcare quality and have received increasing attention in recent years. Intestinal atresia (IA) has a high rate of unplanned reoperations. The purpose of this study is to evaluate the thirty-day unplanned reoperation rates and their risk factors in neonates with intestinal atresias after primary anastomosis surgery, and to construct a predictive nomogram. Methods We developed and internally validated a predictive model from a retrospective cohort of 200 neonates admitted to our hospital for primary anastomosis surgery. The primary outcome was thirty-day unplanned reoperation rates. Independent factors significantly associated with thirty-day unplanned reoperation rates were identified using multivariable logistic regression analysis. The effectiveness of the developed nomogram was evaluated through calibration, discrimination, and clinical utility. Results The incidence of thirty-day unplanned reoperation rates was 11%. Multivariable analysis identified the type of bowel anastomosis and combined meconium peritonitis as independent factors predicting thirty-day unplanned reoperation rates. The derivation model showed good discrimination, with a C-index of 0.791 [95% CI, 0.685 to 0.897], and good calibration [Hosmer–Lemeshow test P = 0.231]. The analysis of the decision curve showed that the nomogram was beneficial in clinical practice. Conclusion We developed a nomogram to predict thirty-day unplanned reoperations of primary anastomosis in neonates with IA. This prediction model may enable assist in clinical decision-making, patient counseling, and treatment planning.
Keywords: Intestinal Atresia, Reoperation, nomogram, risk factor, neonate
Received: 07 Jul 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Lin, Chen, Fang, Chen, Fang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mingkun Liu, 529338548@qq.com
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