| Objective To build and verify a prediction model which can predict airway mucus plugs in children with mycoplasma pneumoniae pneumonia via collecting clinical features, laboratory test results and chest CT findings of these children. Methods A retrospective analysis was performed on the clinical data of 241 children admitted to the Respiratory Department of Anhui Children's Hospital from January 2023 to December 2024. All children had mycoplasma pneumoniae pneumonia and received flexible bronchoscopy, then they were divided into two groups. The first group had 88 children with airway mucus plugs. The second group had 153 children without airway mucus plugs. The clinical data and blood test results were collected. Systemic immune-inflammation index, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were detected. C-reactive protein, lactate dehydrogenase, D-dimer, liver function indicators, chest CT results and bronchoscopy reports were also recorded. Univariate analysis was used to screen different indicators. Multivariate logistic regression was used to make a nomogram model. The receiver operating characteristic curve was employed to check the prediction effect. Results Two groups showed clear differences in length of hospital stay, antibiotic treatment time, fever duration, blood cell indicators, C-reactive protein, lactate dehydrogenase, D-dimer, liver function indicators, inflammation indexes, pleural effusion and bronchial obstruction. All differences had statistical significance. Further regression analysis confirmed five independent risk factors, namely, fever duration, D-dimer, systemic immune-inflammation index, neutrophil-to-lymphocyte ratio and pleural effusion. The new nomogram model showed good performance. Its area under curve was 0.865. The 95% confidence interval ranged from 0.817 to 0.912. Its Youden index was 0.563. Its sensitivity reached 73.9%. Its specificity reached 82.4%.Conclusion The nomogram model uses fever duration, D-dimer, systemic immune-inflammation index, neutrophil-to-lymphocyte ratio and pleural effusion. It can effectively predict the risk of airway mucus plugs in children with mycoplasma pneumoniae pneumonia. |
