Relationship between inflammatory burden index and disease outcomes in children with severe Mycoplasma pneumoniae pneumonia

Li Ruohan; Yin Yue; Chai Xiaolong; Zhang Yanling; Wang Liangliang; Liu Wenjie; Su Wenshuo

doi:10.11986/j.issn.1673-873X.2025.05.15

Abstract：Objective To analyze the relationship between the inflammatory burden index(IBI)and disease outcomes in children with severe Mycoplasma pneumoniae pneumonia(SMPP).Methods A total of 138 children diagnosed with SMPP at a hospi-tal in Hebei from March 2021 to June 2024 were included in the study.According to the disease outcomes,the children were allocated to two groups:the good prognosis group(n=99)and the poor prognosis group(n=39).C-reactive protein(CRP),neutrophil(NEU),and lymphocyte(LYM)levels were measured,and the IBI value was calculated.The IBI values between the two groups were compared,and the predictive value of IBI for disease outcomes was analyzed.The factors influencing the disease outcomes in SMPP children were also explored.Results The CRP,NEU,and IBI values of the poor prognosis group were significantly higher than those of the good prognosis group,while the LYM level was significantly lower in the poor prog-nosis group(P＜0.05).The area under the curve(AUC;95％CI)for CRP,NEU,LYM,and IBI in predicting disease out-comes in children with SMPP was 0.832(0.787-0.882),0.744(0.699-0.794),0.715(0.665-0.760),and 0.917(0.867-0.967),respectively.The AUC for IBI in predicting disease outcomes was significantly higher than for the individual indicators(P＜0.05).In the poor prognosis group,the proportion of patients with the time from onset to hospitalization＞3 days,the affected lung area ≥2/3 of the lung lobe,the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score on ad-mission ≥20,extensive pulmonary consolidation,and fever duration,disease course were all higher/longer than in the good prognosis group,with statistically significant differences(P＜0.05).Logistic stepwise regression analysis showed that time from onset to hospitalization＞3 days(OR=2.275,95％CI:1.304-3.969),APACHE Ⅱ score≥20 on admission(OR=2.550,95％CI:1.411-4.609),and IBI ≥17.43(OR=4.216,95％CI:2.074-8.572)were risk factors for poor disease outcomes in SMPP children(P＜0.05).Conclusion High IBI values are closely associated with poor disease outcomes in children with SMPP and may become a potential biomarker for predicting disease outcomes in these patients.