Construction and validation of a predictive model for allergic rhinitis complicating children with bronchial asthma.

Abstract

This study aimed to investigate the factors influencing the complication of allergic rhinitis in children with bronchial asthma and to construct a nomogram model to predict the occurrence of allergic rhinitis. A total of 190 children with bronchial asthma admitted to our hospital from August 2020 to August 2024 were retrospectively analyzed. The children were randomly divided into the training cohort (133 cases) and validation cohort (57 cases) in a ratio of 7:3. The children in the modeling set were divided into an allergic rhinitis group (n=44) and a nonallergic rhinitis group (n=89) depending on the presence or absence of concomitant allergic rhinitis. A total of 62 cases in 190 children with bronchial asthma had complications with allergic rhinitis, with an incidence of 32.63%. In the training cohort, compared with the children in the nonallergic rhinitis group, percentage of smokers in the household, C-reactive protein (CRP), white blood cell count (WBC), and neutrophils/lymphocytes (NLR) were significantly higher in the allergic rhinitis group (P < 0.05). Multivariable logistic regression analysis showed that smokers in the household; IgE; early use of antibiotics; and elevated CRP, WBC, and NLR were all risk factors for the complication of allergic rhinitis in children with bronchial asthma (P < 0.05). A nomogram prediction model was constructed based on the above risk factors. The C-index of the nomogram was 0.919 (95% CI: 0.742-0.934) and 0.841 (95% CI: 0.773-0.902) for the training cohort and validation cohort, respectively. The Hosmer-Lemeshow test results of the training and validation cohorts were both P > 0.05, suggesting a good model fit. The results of DCA showed that the training and validation cohorts had good threshold probability and clinical net benefit. Smokers in the household, IgE, CRP, WBC, and NLR levels were all risk factors for the complication of allergic rhinitis in children with bronchial asthma. A nomogram model based on these risk factors may be a valuable clinical tool for predicting allergic rhinitis in children with bronchial asthma.