Risk factors and risk prediction for the course of lobar pneumonia in children

Corresponding author: GU Qiang, guqiang106@sina.com

DOI: 10.12201/bmr.202504.00059

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  Abstract: Objective: To identify independent risk factors influencing the disease course of pediatric lobar pneumonia and to develop a nomogram model for risk prediction. Methods: A total of 552 children diagnosed with lobar pneumonia and hospitalized in the Department of Pediatrics at the First Affiliated Hospital of Shihezi University between January 2018 and June 2024 were enrolled. Based on the duration of hospitalization, the patients were divided into a long-course group (≥10 days) 160 case and a short-course group (<10 days) 392 case. Data from both groups were statistically analyzed to construct and internally validate a nomogram prediction model. Results: (1) Bronchoalveolar lavage (BAL) was identified as a protective factor for hospitalization duration, while elevated lactate dehydrogenase (LDH), high fever, mixed infections, and the presence of intrapulmonary complications were independent risk factors for a hospitalization duration ≥10 days. (2) The area under the ROC curve (AUC) was 0.915 for the training set and 0.898 for the test set. The calibration curve of the nomogram, generated via the Bootstrap method, closely aligned with the actual curve. Decision curve analysis demonstrated that the nomogram provided clinical net benefit within a threshold probability range of 0.010–0.890. Conclusion: Mixed pathogen infections, intrapulmonary complications, elevated LDH, and high fever are independent risk factors for prolonged hospitalization (≥10 days) in children with lobar pneumonia. The constructed nomogram model exhibits excellent discriminative ability, calibration, and clinical utility.

  Key words: Lobar pneumonia; Risk factors; Nomogram; Children

  Submit time: 18 April 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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