Predictive Factors for Abnormal Diagnostic Colonoscopy Findings among Pediatric Patients: A Retrospective Cohort Study

Introduction: This study investigated predictive factors associated with abnormal diagnostic findings of pediatric colonoscopies. METHODS: This retrospective study reviewed the medical records of children who underwent diagnostic colonoscopies between January 2004 and March 2025 at the University of Tokyo Hospital. The patients were divided into two groups based on the presence or absence of abnormal colonoscopy findings, and patient backgrounds, clinical symptoms, endoscopic findings, and blood test results were compared between the groups. RESULTS: A total of 112 colonoscopies were performed, among which 73 cases were the first procedure for diagnostic. Abnormal macroscopic and/or histopathological findings were identified in 36 cases within the diagnostic group. In the multivariable analysis, family history of inflammatory bowel disease or hereditary polyposis (odds ratio [OR]: 6.1, 95% confidence interval [CI]: [1.13-37.7], p = 0.035), serum hemoglobin (OR 0.68, 95% CI: [0.47-0.79], p = 0.005), and serum C-reactive protein (OR 1.04, 95% CI: [1.00-1.13], p = 0.043) was independent predictors of abnormal pediatric colonoscopy findings. The predictive model using these three factors was accurate, with an area under the receiver operating characteristic (ROC) of 0.737. CONCLUSION: A detailed preliminary medical history, serum hemoglobin, and serum C-reactive protein may help predict the necessity of pediatric colonoscopy, potentially improving diagnostic efficiency. .