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标准化治疗后肺炎患者肺不张并发症的风险关联模型

Risk association model for atelectasis complication in pneumonia patients following standardized treatment.

作者信息

Xu Mingyi, Fan Minhao, Wang Huixia, Qian Jun, Jiang Yi, Zhu Yifan, Zhao Deyu, Liu Feng, Guo Yun, Li Ling

机构信息

Department of Respiratory Medicine, The Affiliated Wuxi People's Hospital, Wuxi Children's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China.

Department of Respiratory Medicine & Clinical Allergy Center, Affiliated Children's Hospital of Jiangnan University (Wuxi Children's Hospital), Wuxi, China.

出版信息

Front Pediatr. 2024 Nov 28;12:1422074. doi: 10.3389/fped.2024.1422074. eCollection 2024.

Abstract

BACKGROUND

pneumonia (MPP) is a common disease of childhood pneumonia, and atelectasis is a serious comorbidity. Traditional diagnostic methods for MPP are limited by low accuracy, emphasizing the need for improved diagnostic approaches. This study aimed to establish a predictive scoring model for early detection of MPP complicated with atelectasis following standardized treatment.

METHODS

A total of 572 children were retrospectively enrolled, including 40 patients with MPP complicated by atelectasis despite standardized treatment and 532 patients in the non-atelectasis group. Clinical, laboratory, and imaging data within 24 h of admission were collected, including demographic information and various biomarkers. Multivariate logistic regression analysis was employed to identify risk factors and construct a predictive model, evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS

Significant differences were observed between the MPP complicated with atelectasis group and the non-atelectasis group in terms of age, hospital admission time, fever duration, neutrophil percentage and count, CRP, ALT, and LDH levels ( < 0.05). According to the multivariate logistic regression analysis, length of fever, neutrophil ratio, platelet count, ALT, LDH, age were incorporated into the nomogram. The predictive model exhibited a sensitivity of 87.97% and specificity of 77.50% according to the ROC curve.

CONCLUSION

Our study presents a preliminary risk association model incorporating clinical indicators such as fever duration, neutrophil ratio, platelet count, ALT value, LDH value, and age to aid in the early prediction of atelectasis in children with MPP. Given the methodological limitations, the generalizability of our findings is constrained, and this model should be viewed as an initial framework for clinical assessment rather than a definitive tool.

摘要

背景

支原体肺炎(MPP)是儿童肺炎的常见疾病,肺不张是一种严重的合并症。MPP的传统诊断方法准确性较低,因此需要改进诊断方法。本研究旨在建立一个预测评分模型,用于在标准化治疗后早期检测MPP合并肺不张。

方法

回顾性纳入572例儿童,其中40例尽管接受了标准化治疗仍发生MPP合并肺不张,532例为非肺不张组。收集入院24小时内的临床、实验室和影像学数据,包括人口统计学信息和各种生物标志物。采用多因素logistic回归分析确定危险因素并构建预测模型,通过受试者工作特征(ROC)曲线分析进行评估。

结果

MPP合并肺不张组与非肺不张组在年龄、住院时间、发热持续时间、中性粒细胞百分比和计数、CRP、ALT和LDH水平方面存在显著差异(<0.05)。根据多因素logistic回归分析,发热时长、中性粒细胞比例、血小板计数、ALT、LDH、年龄被纳入列线图。根据ROC曲线,该预测模型的敏感性为87.97%,特异性为77.50%。

结论

我们的研究提出了一个初步的风险关联模型,纳入了发热持续时间、中性粒细胞比例、血小板计数、ALT值、LDH值和年龄等临床指标,以帮助早期预测MPP患儿的肺不张。鉴于方法学的局限性,我们研究结果的普遍性受到限制,该模型应被视为临床评估的初始框架,而非确定性工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d88/11634606/7beee29482a9/fped-12-1422074-g001.jpg

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