基于DynNom动态评分构建儿童支原体肺炎并发器官功能障碍的风险预测模型

Construction of a DynNom-based dynamic nomogram model for predicting the risk of organ dysfunction in children with Mycoplasma pneumoniae pneumonia

摘要

目的 分析儿童支原体肺炎并发肺外器官功能障碍的危险因素,建立儿童支原体肺炎并发肺外器官功能障碍的列线图模型。方法 选取2022年1月至2024年7月阜阳市人民医院收治的375例儿童支原体肺炎作为研究对象,根据儿童支原体肺炎并发肺外器官功能障碍情况将其分为肺外器官功能障碍组和无肺外器官功能障碍组。通过LASSO回归及Logistic回归筛选儿童支原体肺炎并发肺外器官功能障碍的危险因素,构建列线图模型,利用受试者工作特征(ROC)曲线、校正曲线及决策曲线评估列线图模型的预测效能。结果 Logistic回归分析结果显示,营养不良、重症肺炎、胸腔积液、鼻炎、呼吸衰竭均是儿童支原体肺炎并发肺外器官功能障碍的危险因素(OR值介于2.853到3.894之间,P<0.05)。儿童支原体肺炎并发肺外器官功能障碍的列线图模型的ROC曲线下面积是0.728(95%CI:0.655~0.802),校正曲线与理想曲线基本拟合;决策曲线显示列线图模型的获益值较高。结论 儿童支原体肺炎并发肺外器官功能障碍的列线图模型具有一定临床实用性。

Abstract

Objective To analyze the risk factors for extrapulmonary organ dysfunction in children with Mycoplasma pneumoniae pneumonia and to establish a nomogram model for extrapulmonary organ dysfunction in these children. Methods A total of 375 children with Mycoplasma pneumoniae pneumonia admitted to Fuyang People's Hospital from January 2022 to July 2024 were selected as the study subjects.They were divided into two groups:those with extrapulmonary organ dysfunction and those without,based on the presence of extrapulmonary organ dysfunction.The risk factors for extrapulmonary organ dysfunction in children with Mycoplasma pneumoniae pneumonia were screened by LASSO regression and logistic regression.A nomogram model was established using R,and the predictive performance of the nomogram model was evaluated by receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis(DCA). Results Logistic regression analysis showed that malnutrition,severe pneumonia,pleural effusion,rhinitis and respiratory failure were all risk factors for extrapulmonary organ dysfunction in children with Mycoplasma pneumoniae pneumonia(OR values ranged from 2.853 to 3.894,P<0.05).The area under ROC curve of the nomogram model for children with Mycoplasma pneumoniae pneumonia complicated with extrapulmonary organ dysfunction was 0.728(95%CI:0.655-0.802),and the calibration curve showed good agreement with the ideal curve.The decision curve showed that the nomogram model had a high net benefit. Conclusion The nomogram model for extrapulmonary organ dysfunction in children with Mycoplasma pneumoniae pneumonia has clinical applicability.

关键词

儿童 / 支原体肺炎 / 器官功能障碍 / 危险因素 / 动态列线图模型

Key words

Child / Mycoplasma pneumoniae pneumonia / organ dysfunction / risk factor / dynamic nomogram model

参考文献

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基金资助

安徽省卫生健康科研项目立项项目(AHWJ2023A20481)