Risk Analysis and Nomogram Model Construction of Necrotizing Pneumonia Caused by Streptococcus Pneumoniae Infection in Children
Objective To analyze the risk factors for Streptococcus pneumoniae necrotizing pneumonia(SPNP)in children and construct a nomogram model based on the identified risk factors accompanied with evaluating its predictive efficacy.Methods Retrospective collection of clinical data from 125 children with Streptococcus pneumoniae infection admitted to Henan Children's Hospital Zhengzhou Children's Hospital from March 2022 to March 2023 was conducted.The children were divided into two groups based on whether they developed secondary necrotizing pneumonia(NP):a non-secondary group and a secondary group.The differences in general clinical data and relevant laboratory indicators between the two groups were compared.Logistic multivariate regression analysis was used to identify the risk factors for secondary NP following Streptococcus pneumoniae infection.R software was used to construct a risk nomogram model for secondary NP after Streptococcus pneumoniae infection,and the model's predictive efficacy was evaluated using goodness-of-fit and receiver operating characteristic(ROC)curves.Results Among 125 children with SP infection,43 had secondary NP,and the incidence of NP was 34.40％(43/125).There were no differences in gender,age,body mass index(BMI),length of hospital stay,peak heat,levels of white blood cells(WBC),platelets(PLT)and neutrophils(Neu)between the non-secondary group and the secondary group(P＞0.05).There were differences in fever duration,hypoxemia,extrapulmonary complications,hypoproteinemia,C-reactive protein(CRP)and procalcitonin(PCT)levels between the two groups(P＜0.05).Logistic regression analysis showed that fever duration,combined with hypoxemia,combined with extrapulmonary complications,combined with hypoproteinemia,CRP and PCT were all risk factors for secondary NP after Streptococcus pneumoniae infection.Based on the above risk factors,the C-index of the risk model of secondary NP after Streptococcus pneumoniae infection was 0.847(95％CI:0.822-0.935),and the prediction efficiency of the model was good.Conclusion Fever duration,concomitant hypoxemia,concomitant extrapulmonary complications,concomitant hypoproteinemia,CRP and PCT levels are risk factors for secondary NP in children following Streptococcus pneumoniae infection.The nomogram model constructed based on these risk factors has good predictive efficacy for assessing the risk of SPNP.
万方数据
维普
