Predictive value of CALLY index combined with NLR for refractory Mycoplasma pneumoniae pneumonia and mechanical ventilation in children
ZHU Yuxin
YANG Li
Abstract：Objective To explore the predictive value of C-reactive protein-albumin-lymphocyte(CALLY)index combined with neutrophil-to-lymphocyte ratio(NLR)for refractory Mycoplasma pneumoniae pneumonia(RMPP)and mechanical ventilation in children.Methods A total of 236 pediatric patients with Mycoplasma pneumoniae pneumonia(MPP)who were hospitalized and treated in Department of Pediatrics,Tongzhou Maternal and Child Health Care Hospital of Beijing from January 2023 to June 2024 were selected.According to the occurrence of RMPP,the pediatric patients were divided into RMPP group(82 cases)and non-RMPP group(154 cases).The pediatric patients were divided into mechanical ventilation group(43 cases)and non-mechanical ventilation group(193 cases)according to whether mechanical ventilation was required for them during treatment.Multivariate logistic regression was used to analyze the influencing factors of RMPP.The value of CALLY index,NLR and their combination in predicting RMPP and mechanical ventilation was analyzed by using receiver operating characteristic(ROC)curve.Results The patients of the RMPP group were older than those of the non-RMPP group,and the levels of C-reactive protein,procalcitonin,lactate dehydrogenase,white blood cell count,neutrophil count and NLR in the RMPP group were higher than those in the non-RMPP group.The hospitalization time of the RMPP group was longer than that of the non-RMPP group,and the levels of albumin,lymphocyte count and CALLY index in the RMPP group were lower than those in the non-RMPP group.The above differences were statistically significant between the two groups(P＜0.05).There were significant differences in antibiotic use,mechanical ventilation rate and treatment effect between the two groups(P＜0.05).Older age and higher levels of NLR,lactate dehydrogenase and procalcitonin were independent risk factors for the occurrence of RMPP(P＜0.05),and higher CALLY index was independent protective factor for the occurrence of RMPP(P＜0.05).Both CALLY index and NLR were helpful in predicting RMPP(P＜0.05),and the combination of the two indicators had a higher predictive efficacy[AUC(95％ CI)=0.927(0.886-0.957)]than a single indicator(CALLY index or NLR)(P＜0.05),with a sensitivity of 79.32％ and a specificity of 92.91％.The NLR of the mechanical ventilation group was higher than that of the non-mechanical ventilation group,and the CALLY index of the mechanical ventilation group was lower than that of the non-mechanical ventilation group,with statistically significant differences between the two groups(P＜0.05).Both CALLY index and NLR were helpful in predicting mechanical ventilation(P＜0.05),and the combination of the two indicators had a higher predictive efficacy[AUC(95％ CI)=0.828(0.774-0.874)]than a single indicator(CALLY index or NLR)(P＜0.05),with a sensitivity of 83.71％ and a specificity of 77.68％.Conclusion CALLY index combined with NLR can be used as an effective indicator for predicting RMPP and mechanical ventilation in children.The combined detection of CALLY index and NLR can help to identify high-risk pediatric patients early,guide clinical decision-making and improve prognosis.
Keywords：Refractory Mycoplasma pneumoniae pneumonia(RMPP)C-reactive protein-albumin-lymphocyte(CALLY)indexNeutrophil-to-lymphocyte ratio(NLR)Mechanical ventilationChildren
Publication Date：2025-03-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 298-302 )