Effect of ambient temperature on pediatric intestinal intussusception incidence in Seoul, Korea: a time series regression analysis using data from the Korean health insurance review and assessment service (HIRA).

Abstract

Pediatric intussusception has been linked to seasonality and ambient temperature, but few studies have examined its short-term temperature dependence at a daily resolution. This study investigated the association between daily ambient temperature and the incidence of pediatric intestinal intussusception. Claims data from the National Health Insurance Service were analyzed for pediatric patients (≤ 10 years old) who underwent procedural or surgical treatment for intussusception in Seoul from 2009 to 2019. Daily average temperature data were obtained from the Korea Meteorological Administration. Seasonal case counts were compared, time-series trends were visualized using a spline function, and a distributed lag non-linear model (DLNM) was applied to assess rate ratios (RRs) while accounting for cumulative lag and non-linearity. Analyses were conducted separately for total, complicated, and uncomplicated cases. Total intussusception case counts peaked in summer, followed by autumn, spring, and winter. The DLNM model with a 0-3-day lag showed a significant RR increase for total and uncomplicated intussusception at temperatures around 7 °C to 20 °C compared to 0 °C. Complicated intussusception exhibited an increase from subzero temperatures to approximately 4 °C, though confidence intervals were wider due to lower case counts. No significant risk Change was observed at temperatures above 20 °C in any group. This study demonstrated a significant association between daily ambient temperature and pediatric intestinal intussusception, with short-term (3-day) cumulative effects suggesting that temperature fluctuations may influence disease incidence.