Construction of a predictive model for performing bronchoalveolar lavage in children with Mycoplasma pneumoniae pneumonia and pulmonary consolidation
WANG Shu-Ye1,2, ZHANG Wen-Bo1,2, WAN Yu2
1. Bengbu Medical College, Bengbu, Anhui 233000, China; 2. Department of Pediatrics, Changzhou No.2 People's Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213000, China
Abstract：Objective To investigate the risk factors for performing bronchoalveolar lavage (BAL) in children with Mycoplasma pneumoniae pneumonia (MPP) and pulmonary consolidation, and to construct a predictive model for performing BAL in these children. Methods A retrospective analysis was performed for the clinical data of 202 children with MPP who were hospitalized in the Department of Pediatrics, Changzhou No. 2 People's Hospital Affiliated to Nanjing Medical University, from August 2019 to September 2022. According to whether BAL was performed, they were divided into BAL group with 100 children and non-BAL group with 102 children. A multivariate logistic regression analysis was used to identify the risk factors for performing BAL in MPP children with pulmonary consolidation. Rstudio software (R4.2.3) was used to establish a predictive model for performing BAL, and the receiver operator characteristic (ROC) curve, C-index, and calibration curve were used to assess the predictive performance of the model. Results The multivariate logistic regression analysis demonstrated that the fever duration, C-reactive protein levels, D-dimer levels, and presence of pleural effusion were risk factors for performing BAL in MPP children with pulmonary consolidation (P<0.05). A nomogram predictive model was established based on the results of the multivariate logistic regression analysis. In the training set, this model had an area under the ROC curve of 0.915 (95%CI: 0.827-0.938), with a sensitivity of 0.826 and a specificity of 0.875, while in the validation set, it had an area under the ROC curve of 0.983 (95%CI: 0.912-0.996), with a sensitivity of 0.879 and a specificity of 1.000. The Bootstrap-corrected C-index was 0.952 (95%CI: 0.901-0.986), and the calibration curve demonstrated good consistency between the predicted probability of the model and the actual probability of occurrence. Conclusions The predictive model established in this study can be used to assess the likelihood of performing BAL in MPP children with pulmonary consolidation, based on factors such as fever duration, C-reactive protein levels, D-dimer levels, and the presence of pleural effusion. Additionally, the model demonstrates good predictive performance.
WANG Shu-Ye,ZHANG Wen-Bo,WAN Yu. Construction of a predictive model for performing bronchoalveolar lavage in children with Mycoplasma pneumoniae pneumonia and pulmonary consolidation[J]. CJCP, 2023, 25(10): 1052-1058.
Zhao J, Ji X, Wang Y, et al. Clinical role of serum interleukin-17a in the prediction of refractory Mycoplasma pneumoniae pneumonia in children[J]. Infect Drug Resist, 2020, 13: 835-843. PMID: 32210598. PMCID: PMC7076716. DOI: 10.2147/IDR.S240034.
Huang L, Huang X, Jiang W, et al. Independent predictors for longer radiographic resolution in patients with refractory Mycoplasma pneumoniae pneumonia: a prospective cohort study[J]. BMJ Open, 2018, 8(12): e023719. PMID: 30567824. PMCID: PMC6303577. DOI: 10.1136/bmjopen-2018-023719.
Jin X, Zhu Y, Zhang Y, et al. Assessment of levels of D-dimer and interferon-γ in pediatric patients with Mycoplasma pneumoniae pneumonia and its clinical implication[J]. Exp Ther Med, 2018, 16(6): 5025-5030. PMID: 30546408. PMCID: PMC6256836. DOI: 10.3892/etm.2018.6873.
Cui N, Zhang H, Chen Z, et al. Prognostic significance of PCT and CRP evaluation for adult ICU patients with sepsis and septic shock: retrospective analysis of 59 cases[J]. J Int Med Res, 2019, 47(4): 1573-1579. PMID: 30656987. PMCID: PMC6460616. DOI: 10.1177/0300060518822404.
Tang JH, Gao DP, Zou PF. Comparison of serum PCT and CRP levels in patients infected by different pathogenic microorganisms: a systematic review and meta-analysis[J]. Braz J Med Biol Res, 2018, 51(7): e6783. PMID: 29846409. PMCID: PMC5995041. DOI: 10.1590/1414-431x20176783.
