Development of a scale for early prediction of refractory Mycoplasma pneumoniae pneumonia in hospitalized children

Abstract

Now there is no clinical scale for early prediction of refractory Mycoplasma pneumoniae pneumonia (RMPP). The aim of this study is to identify indicators and develop an early predictive scale for RMPP in hospitalized children. First we conducted a retrospective cohort study of children with M. pneumoniae pneumonia admitted to Children's Hospital of Nanjing Medical University, China in 2016. Children were divided into two groups, according to whether their pneumonia were refractory and the results were used to develop an early predictive scale. Second we conducted a prospective study to validate the predictive scale for RMPP in children in 2018. 618 children were included in the retrospective study, of which 73 with RMPP. Six prognostic indicators were identified and included in the prognostic assessment scale. The sensitivity of the prognostic assessment scale was 74.0% (54/73), and the specificity was 88.3% (481/545) in the retrospective study. 944 children were included in the prospective cohort, including 92 with RMPP, the sensitivity of the prognostic assessment scale was 78.3% (72/92) and the specificity was 86.2% (734/852). The prognostic assessment scale for RMPP has high diagnostic accuracy and is suitable for use in standard clinical practice.

Figure 1

(A) Study flow. CAP, community-acquired pneumonia; RMPP, refractory M. pneumoniae pneumonia. (B) The first line is the score corresponding to each indicator value. The following is the index included in the scale, and finally the calculated total score and predicted probability. When using, the table should be scaled up and printed on paper, and the score should be calculated using a tool such as a ruler. (C/D) Scale for predicting refractory M. pneumoniae pneumonia by receiver operator characteristic curves. (C) In the retrospective cohort; (D) In the prospective cohort.