Prediction of duodenal ulcers in children with Helicobacter pylori infection.

Background: Helicobacter pylori (HP) infection is a major cause of duodenal ulcers (DUs) in children. DUs can lead to gastrointestinal bleeding and even intestinal perforation, both of which may be life-threatening. This study aimed to establish a predictive model for identifying DUs in children with HP infection, in order to assist primary care pediatricians with early diagnosis and intervention. Methods: A total of 456 children with HP infection admitted to Fujian Children's Hospital and Fujian Maternal and Child Health Hospital were retrospectively included. The training group comprised 307 patients from Fujian Children's Hospital, while the validation group consisted of 149 patients from Fujian Maternal and Child Health Hospital. The patients in the training group were categorized into the HP infection group or HP infection with DU group. Firstly, least absolute shrinkage and selection operator regression analysis was conducted, and the selected variables were subjected to logistic regression analysis to identify the predictors of DUs in children with HP infection. Finally, a nomogram was established for the model. Results: Sex, melena, hemoglobin level, and uric acid level were included in the final prediction model. The area under curve values for the internal training and external validation groups were 0.740 and 0.728, respectively. The Hosmer-Lemeshow tests and calibration curves indicated that the degree of fit and consistency of the model were satisfactory. These decision curve analyses indicated that the model has certain clinical application value. Conclusions: If male children with melena, decreased hemoglobin levels and high uric acid levels are clinically encountered, DUs require high vigilance, and the children should be promptly referred to a facility with pediatric endoscopic capabilities for further diagnosis and treatment.