Evaluation of factors affecting intravenous immunoglobulin resistance and construction of IVIGR risk prediction model in children with Kawasaki disease
Objective To explore the influencing factors of intravenous immunoglobulin resistance(IVIGR)in children with Kawasaki disease(KD),and construct the IVIGR prediction model to provide the basis for the risk stratification nursing of children with KD.Methods Children with KD who were treated in Jiaxing Second Hospital from April 2020 to April 2023 were included in the study subjects.Children with KD were divided into IVIGR and non-IVIGR groups according to whether they developed IVIGR.Stepwise multivariate Logistic regression was used to explore the independent influencing factors of IVIGR in children with KD,and to construct a prediction model of IVIGR in children with KD.The predictive power,the calibration power,and the clinical net benefit of the IVIGR prediction models were evaluated using the receiver operating characteristic curve(ROC),calibration curves,and decision curves.Results A total of 120 children with KD,22 in the IVIG group and 98 in the non-IVIGR group were included.Multivariate Logistic regression showed that hematocrit,total bilirubin,lactate dehydrogenase,and C-reactive protein/albumin ratio were independent influencing factors for the development of IVIGR in children with KD(P<0.05).The area under the ROC curve of the prediction model for IVIGR in KD children was 0.858,which had good predictive ability,calibration ability,and clinical net benefit.Conclusion The IVIGR risk prediction model can be used to predict the occurrence of intravenous IV IGR in children with KD,and it is a simple and practical tool to achieve risk-graded care.
万方数据
维普
