A Study of the Risk of Diarrhea Secondary to Pneumonia in Neonates and the Development of Risk Prediction Model
Objective To investigate the risk of secondary diarrhea caused by pneumonia in newborns,and to develop and validate a risk prediction model.Methods A total of 432 neonates with pneumonia were selected from July,2022 to December,2023.These children were randomly divided into a model training group (302 cases)and a validation group (130 cases)with a ratio of 7︰3.The relevant factors that could affect the secondary diarrhea of neonatal pneumonia children were collected for model development,and the children in the model training group were divided into the diarrhea group and the diarrhea group according to the occurrence of secondary diarrhea.The general information,disease and treatment-related factors and laboratory indicators of the children in the two groups were compared.Multivariate logistic regression was applied by least absolute shrinkage and selection operator (LASSO)to train and validate the nomographic model.Results Among 302 children with neonatal pneumonia in the model training group,81 cases (26.82％) had diarrhea.According to the LASSO regression results,multivariate logistic regression analysis showed as follows:gestational age,feeding pattern,invasive operation,antibiotic combination,glucocorticoid use,microecological preparation use,and hospital stay were independent influencing factors for neonatal pneumonia secondary diarrhea (P<0.05).The area under receiver operating characteristic curve (ROC)of model group was 0.779,with 95％ CI of (0.719-0.838),sensitivity of 79.0％,and specificity of 63.8％.In the validation group,the area under ROC curve was 0.751,with 95％ CI of (0.689-0.813),sensitivity of 85.2％,and specificity of 54.3％.The slope of the calibration curve of the model training group and the validation group was 1,and the intercept was 0.000.The model curve and the ideal model were basically synthesized diagonals.H-L goodness of fit test was optimal (P>0.05). The results of clinical effectiveness analysis showed that the net benefit of using this model to predict neonatal pneumonia secondary diarrhea was the highest when the prediction probability threshold was 0.15-0.75.Conclusion Secondary diarrhea in neonates with pneumonia is mainly affected by gestational age,feeding mode,invasive operation and other factors.The nomogram model established in this study has a high accuracy and differentiation in predicting the risk of neonatal pneumonia secondary diarrhea.
Neonatal pneumoniaSecondary diarrheaMulti-factor analysisNomogram model
NETL
NSTL
万方数据
