Threshold effect of white blood cell count on the risk of refractory Mycoplasma pneumoniae pneumonia in pediatric patients: A retrospective cohort study.

IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Lingke Liu, Xuan Wenjie, Yana Wang, Xiaoxian Wang
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引用次数: 0

Abstract

Refractory Mycoplasma pneumoniae pneumonia (RMPP) remains a major challenge in pediatric respiratory infections, with limited early predictors for disease progression. White blood cell (WBC) count is a widely used biomarker, but its relationship with RMPP risk has not been fully elucidated. This study investigates the threshold effect of WBC count on RMPP development to enhance risk stratification and early intervention strategies. A retrospective cohort study was conducted on pediatric patients diagnosed with MPP. WBC count was analyzed as both a continuous variable and stratified into quartiles to evaluate its association with RMPP risk using multivariable logistic regression. A threshold effect analysis was performed, and model selection was determined by the log-likelihood ratio test (P = .017). Adjustments were made for age, gender, weight, inflammatory markers (C-reactive protein, interleukin-6, γ-IFN), and metabolic indicators (lactate dehydrogenase, lactate, ALT, AST). A nonlinear relationship between WBC count and RMPP risk was identified. A threshold at WBC = 14.3 × 109/L was detected, which serves as a critical diagnostic indicator. When WBC count exceeds this threshold, it strongly suggests the development of RMPP. For WBC levels below 14.3 × 109/L, each 1 × 109/L increase was associated with a 20% higher RMPP risk (OR = 1.2, 95% CI: 1.1-1.2, P < .001), indicating that moderate WBC elevations are a strong predictor of disease progression. The WBC count was associated with the development of refractory RMPP. WBC count could be used as a crucial biomarker for risk stratification and clinical decision-making in pediatric MPP, providing clinicians with a clear threshold for early intervention and close monitoring.

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白细胞计数对小儿难治性肺炎支原体肺炎风险的阈值效应:一项回顾性队列研究。
难治性肺炎支原体肺炎(RMPP)仍然是儿童呼吸道感染的主要挑战,疾病进展的早期预测指标有限。白细胞(WBC)计数是一种广泛使用的生物标志物,但其与RMPP风险的关系尚未完全阐明。本研究探讨白细胞计数对RMPP发展的阈值效应,以加强风险分层和早期干预策略。对诊断为MPP的儿科患者进行回顾性队列研究。WBC计数作为连续变量和分层四分位数进行分析,使用多变量逻辑回归评估其与RMPP风险的关系。进行阈值效应分析,采用对数似然比检验确定模型选择(P = 0.017)。对年龄、性别、体重、炎症标志物(c反应蛋白、白细胞介素-6、γ-IFN)和代谢指标(乳酸脱氢酶、乳酸、ALT、AST)进行调整。WBC计数与RMPP风险之间存在非线性关系。检测到的阈值为WBC = 14.3 × 109/L,是诊断的关键指标。当白细胞计数超过该阈值时,强烈提示RMPP的发展。对于WBC水平低于14.3 × 109/L的患者,每增加1 × 109/L, RMPP风险增加20% (OR = 1.2, 95% CI: 1.1-1.2, P
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来源期刊
Medicine
Medicine 医学-医学:内科
CiteScore
2.80
自引率
0.00%
发文量
4342
审稿时长
>12 weeks
期刊介绍: Medicine is now a fully open access journal, providing authors with a distinctive new service offering continuous publication of original research across a broad spectrum of medical scientific disciplines and sub-specialties. As an open access title, Medicine will continue to provide authors with an established, trusted platform for the publication of their work. To ensure the ongoing quality of Medicine’s content, the peer-review process will only accept content that is scientifically, technically and ethically sound, and in compliance with standard reporting guidelines.
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