首页|Age and mean platelet volume-based nomogram for predicting the therapeutic efficacy of metoprolol in Chinese pediatric patients with vasovagal syncope

Age and mean platelet volume-based nomogram for predicting the therapeutic efficacy of metoprolol in Chinese pediatric patients with vasovagal syncope

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Background Vasovagal syncope(VVS)is the most common type of orthostatic intolerance in children.We investigated whether platelet-related factors related to treatment efficacy in children suffering from VVS treated with metoprolol.Methods Metoprolol-treated VVS patients were recruited.The median duration of therapy was three months.Patients were followed and divided into two groups,treament-effective group and treatment-ineffective group.Logistic and least absolute shrinkage selection operator regressions were used to examine treatment outcome variables.Receiver-operating character-istic(ROC)curves,precision-recall(PR)curves,calibration plots,and decision curve analyses were used to evaluate the nomogram model.Results Among the 72 patients who complete the follow-up,treatment-effective group and treatment-ineffective group included 42(58.3％)and 30(41.7％)cases,respectively.The patients in the treatment-effective group exhibited higher mean platelet volume(MPV)[(11.0±1.0)fl vs.(9.8±1.0)fl,P＜0.01]and platelet distribution width[12.7％(12.3％,14.3％)vs.11.3％(10.2％,12.2％),P＜0.01]than those in the treatment-ineffective group.The sex ratio was significantly different(P=0.046).A fit model comprising age[odds ratio(OR)=0.766,95％confidence interval(CI)=0.594-0.987]and MPV(OR=5.613,95％CI=2.297-13.711)might predict therapeutic efficacy.The area under the curve of the ROC and PR curves was computed to be 0.85 and 0.9,respectively.The P value of the Hosmer-Lemeshow test was 0.27.The decision curve analysis confirmed that managing children with VVS based on the predictive model led to a net advantage ranging from 0.01 to 0.58.The nomogram is convenient for clinical applications.Conclusion A novel nomogram based on age and MPV can predict the therapeutic benefits of metoprolol in children with VVS.

MetoprololNomogramRetrospective studyTherapeutic effectVasovagal syncope

Xiao-Juan Du、Ya-Qian Huang、Xue-Ying Li、Ying Liao、Hong-Fang Jin、Jun-Bao Du

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Department of Pediatrics,Peking University First Hospital,No.1 Xi'an Men Street,West District,Beijing 100034,China

Department of Pediatrics,Peking University First Hospital,No.1 Xi'anmen Street,West District,Beijing 100034,China

State Key Laboratory of Vascular Homeostasis and Remodeling,Peking University,No.38,Xueyuan Road,Haidian District,Beijing 100191,China

Department of Statistics,Peking University First Hospital,Beijing 100034,China

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National High-Level Hospital Clinical Research FundingClinical Medicine Plus X-Young Scholars ProjectFundamental Research Funds for the Central Universities,China

2022CR59PKU2022LCXQ028

2024

10.1007/s12519-024-00802-5

世界儿科杂志(英文版)

世界儿科杂志(英文版)

CSTPCD
ISSN：
年,卷(期)：2024.20(9)