Diao Yu, Yuran Huang, Shipeng Xu, Ling Zeng, Yunfeng Luo, Hongli Wang, Lan Hu
{"title":"外周血有核红细胞的评估增加了28天重症肺炎婴儿重症疾病评分的预测价值","authors":"Diao Yu, Yuran Huang, Shipeng Xu, Ling Zeng, Yunfeng Luo, Hongli Wang, Lan Hu","doi":"10.1002/ppul.27460","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the predictive value of combining nucleated red blood cells (NRBC) with the pediatric critical illness score (PCIS) in infants with severe pneumonia at 28 days.</p><p><strong>Methods: </strong>This retrospective study was conducted at the Pediatric Intensive Care Unit (PICU) of the First People's Hospital of Bijie and included infants with severe pneumonia from September 1, 2021, to August 31, 2022. Demographic, clinical, and laboratory data were extracted from electronic medical records, and the differences between the groups were compared. Variables showing significant differences were included in binary multivariable logistic regression analysis to explore independent risk factors for mortality in infants with severe pneumonia. A receiver operating characteristic (ROC) curve was used to evaluate the predictive value of patient outcomes at 28 days.</p><p><strong>Results: </strong>The study included 128 patients; at 28 days, 96 survived (survivor group), and 32 had died (nonsurvivor group). Compared with the survivor group, the nonsurvivor group had lower levels of platelets [348 (239-496) versus 431 (324-540) ×10<sup>9</sup>/L; p = 0.023], albumin [35.7 ± 5.2 vs. 37.9 ± 4.4 g/L; p = 0.022], CD3 [36.9 ± 1.7 vs. 47.6 ± 1.8%; p ＜ 0.001], CD4 [20.4 ± 1.2 vs. 23.6 ± 1.9%; p ＜ 0.001], IgG [4.9 ± 1.0 vs. 6.4 ± 0.7 g/L; p ＜ 0.001], IgA [0.5 ± 0.1 vs. 0.8 ± 0.1 g/L; p ＜ 0.001], 25-hydroxyvitamin D(25(OH)D) [21.1 ± 1.0 vs. 30.7 ± 1.36 ng/mL; p ＜ 0.001], PCIS [72.8 ± 7.8 vs. 87.5 ± 6.2; P＜0.001], and a greater NRBC level [0.450 (0.162-0.832) vs. 0.185 (0.100-0.500) ×10<sup>9</sup>/L; p = 0.005]. Binary multivariable logistic regression analysis revealed that the NRBC count (odds ratio (OR) = 2.46, 95% confidence interval [CI] 1.427-4.239; p = 0.001) and PCIS (OR = 0.775, 95% CI: 0.644-0.934; p = 0.008) were independent predictors of 28-day survival in infants with severe pneumonia. The PCIS had an area under the curve (AUC) of 0.782 (95% CI: 0.680-0.884), NRBC had an AUC of 0.719 (95% CI: 0.622-0.816), and when the NRBC and PCIS were combined, the AUC was 0.929 (95% CI: 0.880-0.978).</p><p><strong>Conclusion: </strong>The NRBC count and PCIS are risk factors for the prognosis of infants with severe pneumonia, and their combination can increase the predictive value of patient outcomes at 28 days.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":" ","pages":"e27460"},"PeriodicalIF":2.7000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluation of Nucleated Red Blood Cells in Peripheral Blood Increases the Predictive Value of Pediatric Critical Illness Score in Infants With Severe Pneumonia at 28 Days.\",\"authors\":\"Diao Yu, Yuran Huang, Shipeng Xu, Ling Zeng, Yunfeng Luo, Hongli Wang, Lan Hu\",\"doi\":\"10.1002/ppul.27460\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to evaluate the predictive value of combining nucleated red blood cells (NRBC) with the pediatric critical illness score (PCIS) in infants with severe pneumonia at 28 days.</p><p><strong>Methods: </strong>This retrospective study was conducted at the Pediatric Intensive Care Unit (PICU) of the First People's Hospital of Bijie and included infants with severe pneumonia from September 1, 2021, to August 31, 2022. Demographic, clinical, and laboratory data were extracted from electronic medical records, and the differences between the groups were compared. Variables showing significant differences were included in binary multivariable logistic regression analysis to explore independent risk factors for mortality in infants with severe pneumonia. A receiver operating characteristic (ROC) curve was used to evaluate the predictive value of patient outcomes at 28 days.</p><p><strong>Results: </strong>The study included 128 patients; at 28 days, 96 survived (survivor group), and 32 had died (nonsurvivor group). Compared with the survivor group, the nonsurvivor group had lower levels of platelets [348 (239-496) versus 431 (324-540) ×10<sup>9</sup>/L; p = 0.023], albumin [35.7 ± 5.2 vs. 37.9 ± 4.4 g/L; p = 0.022], CD3 [36.9 ± 1.7 vs. 47.6 ± 1.8%; p ＜ 0.001], CD4 [20.4 ± 1.2 vs. 23.6 ± 1.9%; p ＜ 0.001], IgG [4.9 ± 1.0 vs. 6.4 ± 0.7 g/L; p ＜ 0.001], IgA [0.5 ± 0.1 vs. 0.8 ± 0.1 g/L; p ＜ 0.001], 25-hydroxyvitamin D(25(OH)D) [21.1 ± 1.0 vs. 30.7 ± 1.36 ng/mL; p ＜ 0.001], PCIS [72.8 ± 7.8 vs. 87.5 ± 6.2; P＜0.001], and a greater NRBC level [0.450 (0.162-0.832) vs. 0.185 (0.100-0.500) ×10<sup>9</sup>/L; p = 0.005]. Binary multivariable logistic regression analysis revealed that the NRBC count (odds ratio (OR) = 2.46, 95% confidence interval [CI] 1.427-4.239; p = 0.001) and PCIS (OR = 0.775, 95% CI: 0.644-0.934; p = 0.008) were independent predictors of 28-day survival in infants with severe pneumonia. The PCIS had an area under the curve (AUC) of 0.782 (95% CI: 0.680-0.884), NRBC had an AUC of 0.719 (95% CI: 0.622-0.816), and when the NRBC and PCIS were combined, the AUC was 0.929 (95% CI: 0.880-0.978).</p><p><strong>Conclusion: </strong>The NRBC count and PCIS are risk factors for the prognosis of infants with severe pneumonia, and their combination can increase the predictive value of patient outcomes at 28 days.</p>\",\"PeriodicalId\":19932,\"journal\":{\"name\":\"Pediatric Pulmonology\",\"volume\":\" \",\"pages\":\"e27460\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Pulmonology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ppul.27460\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/24 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Pulmonology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ppul.27460","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/24 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
Evaluation of Nucleated Red Blood Cells in Peripheral Blood Increases the Predictive Value of Pediatric Critical Illness Score in Infants With Severe Pneumonia at 28 Days.
Objective: This study aimed to evaluate the predictive value of combining nucleated red blood cells (NRBC) with the pediatric critical illness score (PCIS) in infants with severe pneumonia at 28 days.
Methods: This retrospective study was conducted at the Pediatric Intensive Care Unit (PICU) of the First People's Hospital of Bijie and included infants with severe pneumonia from September 1, 2021, to August 31, 2022. Demographic, clinical, and laboratory data were extracted from electronic medical records, and the differences between the groups were compared. Variables showing significant differences were included in binary multivariable logistic regression analysis to explore independent risk factors for mortality in infants with severe pneumonia. A receiver operating characteristic (ROC) curve was used to evaluate the predictive value of patient outcomes at 28 days.
Results: The study included 128 patients; at 28 days, 96 survived (survivor group), and 32 had died (nonsurvivor group). Compared with the survivor group, the nonsurvivor group had lower levels of platelets [348 (239-496) versus 431 (324-540) ×109/L; p = 0.023], albumin [35.7 ± 5.2 vs. 37.9 ± 4.4 g/L; p = 0.022], CD3 [36.9 ± 1.7 vs. 47.6 ± 1.8%; p ＜ 0.001], CD4 [20.4 ± 1.2 vs. 23.6 ± 1.9%; p ＜ 0.001], IgG [4.9 ± 1.0 vs. 6.4 ± 0.7 g/L; p ＜ 0.001], IgA [0.5 ± 0.1 vs. 0.8 ± 0.1 g/L; p ＜ 0.001], 25-hydroxyvitamin D(25(OH)D) [21.1 ± 1.0 vs. 30.7 ± 1.36 ng/mL; p ＜ 0.001], PCIS [72.8 ± 7.8 vs. 87.5 ± 6.2; P＜0.001], and a greater NRBC level [0.450 (0.162-0.832) vs. 0.185 (0.100-0.500) ×109/L; p = 0.005]. Binary multivariable logistic regression analysis revealed that the NRBC count (odds ratio (OR) = 2.46, 95% confidence interval [CI] 1.427-4.239; p = 0.001) and PCIS (OR = 0.775, 95% CI: 0.644-0.934; p = 0.008) were independent predictors of 28-day survival in infants with severe pneumonia. The PCIS had an area under the curve (AUC) of 0.782 (95% CI: 0.680-0.884), NRBC had an AUC of 0.719 (95% CI: 0.622-0.816), and when the NRBC and PCIS were combined, the AUC was 0.929 (95% CI: 0.880-0.978).
Conclusion: The NRBC count and PCIS are risk factors for the prognosis of infants with severe pneumonia, and their combination can increase the predictive value of patient outcomes at 28 days.
期刊介绍：
Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases.
PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
