Construction of a Predictive Model of Respiratory Endoscopic Intervention in Children with Lobar Pneumonia Caused by Mycoplasma Pneumoniae Infection

Objectives: This study aimed to analyze the clinical features of children with lobar pneumonia caused by Mycoplasma pneumoniae (MP) infection, to provide a prognostic evaluation of interventional bronchoscopy, and to explore the independent risk factors for bronchoscopic intervention in children with lobar pneumonia caused by MP infection. We also aimed to construct an early-warning model of bronchoscopic intervention, so as to provide an objective evaluation tool for clinicians. Methods: : We collected the clinical data from 533 children with lobar pneumonia caused by MP infection. The patients were divided into three groups according to the interventional indications for bronchoscopy and whether they were treated with bronchoscopic intervention, and the clinical features and prognosis of the three groups were compared. Binary logistic regression analysis was performed on the indicators with a significance value of P < 0.05, which we retrieved from the comparative analysis between the first two groups, in order to uncover the independent risk factors and regression equations concerning bronchoscopic intervention. The regression coefficient (β) of our regression model was then used to score related values in the model so as to construct a predictive scoring model of bronchoscopic intervention for the treatment of children with lobar pneumonia caused by MP infection. Results: : Children with lobar pneumonia caused by MP infection who demonstrated absolute indications for bronchoscopy exhibited more severe clinical manifestations, and children without absolute indications for bronchoscopy achieved a better prognosis even without bronchoscopic intervention. To establish our early-warning model of bronchoscopic intervention for children with lobar pneumonia caused by MP infection, we utilized the following indices: a C-reactive protein (CRP) ≥ 20.94 mg/L (β 1 = 2.253) received 3 points; a fever duration before bronchoscopy ≥ 6.5 d (β 2 = 1.424), lactate dehydrogenase (LDH) ≥ 461.5 U/L (β 3 = 1.246), or fever (β 4 = 1.223), each received 2 points; and if complicated by pleural effusion (β 5 = 0.841), 1 point, for a total score of 10 points. Conclusions: : When the score for the children with lobar pneumonia caused by MP infection was ≥6, the possibility of bronchoscopic intervention for treatment was higher than 80%. The higher the score, the greater the possibility of bronchoscopic intervention.