Nomogram construction based on characteristic genes and clinical variables to predict the risk of multiple organ dysfunction syndrome caused by influenza in children.

IF 1.5 4区 医学 Q2 PEDIATRICS
Translational pediatrics Pub Date : 2025-01-24 Epub Date: 2025-01-21 DOI:10.21037/tp-24-386
Ming Chi, Fei Liu, Haifeng Chi, Ping Liu, Bo Xu, Dawei Zhang
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引用次数: 0

Abstract

Background: Screening for risk factors for the occurrence of multiple organ dysfunction syndrome (MODS) caused by pediatric influenza is an essential approach to improving treatment interventions and stratifying prognosis. This study aimed to select characteristic genes in MODS samples, demonstrate the correlation between characteristic genes and clinical variables, show the changes in expression levels of characteristic genes in the progression of MODS, and establish a predictive prolonged MODS (PM) line chart model.

Methods: We downloaded the pediatric influenza blood messenger ribonucleic acid (mRNA) dataset (GSE236877) from the Gene Expression Omnibus (GEO) database. Multiple logistic regression analyses were employed to screen for risk factors and independent risk factors, and to establish nomogram model. The receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of variables on disease occurrence, where a larger area under the curve (AUC) indicates better predictive performance. Calibration curves and the Hosmer-Lemeshow goodness-of-fit test were utilized to describe whether the curves exhibited deviation. Decision curve analysis (DCA) was employed to assess the predictive efficacy of the model.

Results: SLC12A7 was an independent risk factor that increased the risk of PM (OR =0.356, P<0.001). GNA15 (OR =4.598, P<0.001) and EMP1 (OR =2.158, P=0.002) were protective factors that reduced the risk of PM occurrence. These three genes were combined with clinical variables, including age, influenza virus type, and bacterial co-infection, to construct a nomogram model for predicting the risk of MODS in children with influenza. The AUC of the nomogram score was 0.946, which was larger than the AUC of individual genes and clinical variables. Nomogram model can increase the net benefit of patients compared with clinical variables.

Conclusions: TGFBI, SLC12A7, LY86, HAL, CASP5, RETN, ESPL1, TULP2, DEFB114, EMP1, GNA15, GPAA1 were characteristic genes that distinguished between never MODS (NM) and PM samples. SLC12A7, GNA15, and EMP1 can serve as independent predictive factors for MODS. A nomogram model based on SLC12A7, GNA15, EMP1, and clinical variables (age, influenza virus type, and bacterial co-infection status) demonstrated better predictive performance for the risk of MODS in children with influenza compared to clinical variables and single genes.

基于特征基因和临床变量的Nomogram构建预测儿童流感致多器官功能障碍综合征的风险。
背景:筛查儿童流感引起的多器官功能障碍综合征(MODS)发生的危险因素是改善治疗干预和分层预后的重要途径。本研究旨在筛选MODS样本中的特征基因,验证特征基因与临床变量的相关性,显示特征基因在MODS进展过程中的表达水平变化,建立预测延长型MODS (PM)的线形图模型。方法:从Gene Expression Omnibus (GEO)数据库下载儿童流感血信使核糖核酸(mRNA)数据集(GSE236877)。采用多元logistic回归分析筛选危险因素和独立危险因素,建立nomogram模型。采用受试者工作特征(ROC)曲线评价变量对疾病发生的预测效果,曲线下面积(AUC)越大,预测效果越好。采用校正曲线和Hosmer-Lemeshow拟合优度检验来描述曲线是否出现偏差。采用决策曲线分析(DCA)对模型的预测效果进行评价。结果:SLC12A7是增加PM发生风险的独立危险因素(OR =0.356), PGNA15 (OR =4.598)、PEMP1 (OR =2.158, P=0.002)是降低PM发生风险的保护因素。将这三个基因与年龄、流感病毒类型、细菌共感染等临床变量结合,构建预测流感患儿MODS风险的nomogram模型。nomogram评分的AUC为0.946,大于个体基因和临床变量的AUC。与临床变量相比,Nomogram模型能够提高患者的净收益。结论:TGFBI、SLC12A7、LY86、HAL、CASP5、RETN、ESPL1、TULP2、DEFB114、EMP1、GNA15、GPAA1是区分非MODS (NM)和PM的特征基因。SLC12A7、GNA15和EMP1可作为MODS的独立预测因子。与临床变量和单基因相比,基于SLC12A7、GNA15、EMP1和临床变量(年龄、流感病毒类型和细菌共感染状态)的nomogram模型对流感患儿MODS风险的预测效果更好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Translational pediatrics
Translational pediatrics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
4.50
自引率
5.00%
发文量
108
期刊介绍: Information not localized
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