Construction and Validation of a Nomogram Model to Predict the Severity of Mycoplasma pneumoniae Pneumonia in Children

Abstract

Background

This study aimed to develop a nomogram model for early prediction of the severe Mycoplasma pneumoniae pneumonia (MPP) in children.

Methods

A retrospective analysis was conducted on children with MPP, classifying them into severe and general MPP groups. The risk factors for severe MPP were identified using Logistic Stepwise Regression Analysis, followed by Multivariate Regression Analysis to construct the nomogram model. The model’s discrimination was evaluated using a receiver operating characteristic curve, its calibration with a calibration curve, and the results were visualized using the Hosmer–Lemeshow goodness-of-fit test.

Results

Univariate analysis revealed that age, duration of fever, length of hospital-stay, decreased sounds of breathing, respiratory rate, hypokalemia, and incidence of co-infection were significantly different between severe and general MPP. Significant differences (p < 0.05) were also observed in C-reactive protein, procalcitonin, peripheral blood lymphocyte count, neutrophil-to-lymphocyte ratio, ferritin, lactate dehydrogenase, alanine aminotransferase, interleukin-6, immunoglobulin A, and CD4⁺ T cells between the two groups. Logistic Stepwise Regression Analysis showed that age, decreased sounds of breathing, respiratory rate, duration of fever (OR = 1.131; 95% CI: 1.060–1.207), length of hospital-stay (OR = 1.415; 95% CI: 1.287–1.555), incidence of co-infection (OR = 1.480; 95% CI: 1.001–2.189), ferritin level (OR = 1.003; 95% CI: 1.001–1.006), and LDH level (OR = 1.003; 95% CI: 1.001–1.005) were identified as risk factors for the development of severe MPP (p < 0.05 in all). The above factors were applied in constructing a nomogram model that was subsequently tested with 0.862 of the area under the ROC curve.

Conclusion

Age, decreased sound of breathing, respiratory rate, duration of fever, length of hospital-stay, co-infection with other pathogen(s), ferritin level, and LDH level were the significant contributors for the establishment of a nomogram model to predict the severity of MPP in children.

Keywords:

• Mycoplasma pneumoniae pneumonia
• nomogram
• severity prediction

Data Sharing Statement

The original data included in this study are presented in this article. Further inquiries can be directed to the corresponding author.

Ethics Approval and Consent to Participate

This study was approved by the Ethic Committee of the Tianjin Children’s Hospital (No. 022-LXKY-004). All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from individual participants and their legal guardians.

Acknowledgments

We thank all participants and staff of this study and the physicians at the Tianjin Children’s Hospital affiliated to Tianjin University.

Disclosure

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Additional information

Funding

This study was financially supported by Tianjin Municipal Health Commission Key Discipline Special Fund (TJWJ2022XK038) and Tianjin Key Medical Discipline (Specialty) Construction Project (No. TJYXZDXK-040A).