Risk factors analysis and predictive model construction for liver damage in children with Mycoplasma pneumoniae pneumonia

ZHANG Huan; LI Hongxia

doi:10.3969/j.issn.1007-8134.2024.05.014

Abstract：Objective To analyz the influencing factors of liver damage in children with Mycoplasma pneumoniae pneumonia(MPP)and construct a column chart model for predicting liver damage in children with liver damage.Methods A retrospective analysis was conducted on the data of 398 pediatric MPP patients admitted to our hospital from September 2021 to August 2023.They were grouped into liver damage group and no liver damage group based on whether liver damage occurred.Univariate analysis was conducted on the general information,imaging data,biochemical indicators,and treatment information of the patients,while multivariate analysis was applied to screen for related factors in the occurrence of liver damage.R software was applied to construct a risk model for predicting liver damage in children with MPP,area under the ROC curve(AUC curve)and calibration curve were applied to test the predictive performance of the model.Results A total of 57 children developed liver damage,with an incidence rate of 14.32%;the proportions of patients with a fever duration of≥1 week,pleural effusion,lung consolidation,involvement of myocardium,using macrolides antibiotics(MA)after 5 days of onset,C-reactive protein(CRP)>10 mg/L,and D-dimer(D-D)≥200 μg/L in the liver damage group were higher than those in the no liver damage group(P＜0.05);Logistic regression analysis showed that the main factors affecting the occurrence of liver damage in children with MPP included pleural effusion,lung consolidation,involvement of myocardium,application of MA after 5 days of onset,CRP＞10mg/L,D-D≥200 μg/L(P＜0.05);model validation showed that the AUC was 0.837(95%CI:0.770～0.904),and the calibration curve fitted well,the goodness of fit HL test was χ2=6.759,and P=0.551.Conclusion A column chart model constructed based on whether there is pleural effusion,whether there is lung consolidation,whether there is myocardial involvement,and the application of MA time,CRP,D-D can better predict the probability of liver damage in children with MPP.