Jornal de pediatria最新文献

{"title":"Morbidity trend and space-time clusters of COVID-19 occurrence in children and adolescents","authors":"Camila Beatriz Alves da Rocha ,&nbsp;Lúbia Maieles Gomes Machado ,&nbsp;Pãmela Rodrigues de Souza Silva ,&nbsp;Bruna Hinnah Borges Martins de Freitas ,&nbsp;Iara Denise Endruweit Battisti ,&nbsp;Emerson Soares dos Santos ,&nbsp;Silvana Margarida Benevides Ferreira","doi":"10.1016/j.jped.2023.10.004","DOIUrl":"10.1016/j.jped.2023.10.004","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the morbidity trend and space-time distribution clusters of confirmed COVID-19 cases in children and adolescents.</p></div><div><h3>Method</h3><p>An ecological study of COVID-19 cases confirmed in the Information System from 2020 to 2022 in the age group from 0 to 19 years old, residents in Mato Grosso municipalities, Brazilian Midwest region. A trend analysis of the monthly morbidity rate of cases/100,000 inhabitants was used, following <em>Prais-Winsten</em>'s regression. A space-time distribution of the Bayesian incidence rate per 100,000 inhabitants was performed, in addition to a space-time scan to identify high-risk clusters.</p></div><div><h3>Results</h3><p>Of all 79,592 COVID-19 cases studied, 51.6% were in females and 44.21% in people aged 15–19 years old. The mean monthly rate was 265.87 cases per 100,000 inhabitants, with a stationary trend in the period analyzed (Monthly Percentage Variation [MPV]) = 12.15; CI_95%[MPV]: -0.73;26.70). The morbidity rate due to COVID-19 was higher in the female gender (283.14/100,000 inhabitants) and in the age group from 15 to 19 years old (485.90/100,000 inhabitants). An increasing trend was observed with a greater monthly time variation of 14.42% (CI_95%[MPV]: 1.28;29.28)] among those aged from 10 to 14 years old. The primary cluster, which was also the one with the highest Relative Risk (RR = 5,16, <em>p</em>-value = 0.001), included 19 municipalities located in the North health macro-region.</p></div><div><h3>Conclusion</h3><p>The findings indicated a monthly stationary trend in the study population, an increase in the age group from 10 to 14 years old, and areas at a higher risk for the disease in the North health macro-region of the state.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755723001341/pdfft?md5=1f560e80f2f1972e74696bd8a4783d55&pid=1-s2.0-S0021755723001341-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89718392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing palliative care, based on family-centered care, in a highly complex neonatal unit","authors":"Ana Morillo Palomo,&nbsp;Jordi Clotet Caba,&nbsp;Marta Camprubí Camprubí,&nbsp;Elena Blanco Díez,&nbsp;Joel Silla Gil,&nbsp;Ana Riverola de Veciana","doi":"10.1016/j.jped.2023.09.009","DOIUrl":"10.1016/j.jped.2023.09.009","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the causes and circumstances of neonatal mortality and determine whether the implementation of a palliative care protocol has improved the quality of end-of-life care.</p></div><div><h3>Methods</h3><p>A retrospective observational study including all patient mortalities between January 2009 and December 2019. Cause of death and characteristics of support during the dying process were collected. Two periods, before and after the implementation of a palliative care protocol, were compared.</p></div><div><h3>Results</h3><p>There were 344 deaths. Congenital malformations were the most frequent cause of death (45.6 %). Most patients died after the transition to palliative care (74.4 %). The most frequently cited criteria for initiating transition of care was poor neurocognitive prognosis (47.2 %). Parents accompanied their children in the dying process in 72 % of cases. Twenty-three percent of patients died outside the Neonatal Intensive Care Unit after being transferred to a private room to enhance family intimacy. After the addition of the palliative care protocol, statistically significant differences were observed in the support and patient experience during the dying process.</p></div><div><h3>Conclusions</h3><p>The most frequent causes of death were severe congenital malformations. Most patients died accompanied by their parents after the transition to palliative care. The implementation of a palliative care protocol helped to improve the family-centered end-of-life care.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755723001250/pdfft?md5=6c57780f4fafa610680f1f90166ce99a&pid=1-s2.0-S0021755723001250-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136127997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between placental efficiency with anthropometry and nutritional phenotypes in full-term newborns from the 2010/2011 BRISA birth cohort","authors":"Marina Papa Penteado ,&nbsp;Carlos Grandi ,&nbsp;Lívia dos Santos Rodrigues ,&nbsp;Viviane Cunha Cardoso","doi":"10.1016/j.jped.2023.11.011","DOIUrl":"10.1016/j.jped.2023.11.011","url":null,"abstract":"<div><h3>Objective</h3><p>To study the association between placental efficiency with anthropometry and nutritional phenotypes in full-term newborns from a birth cohort.</p></div><div><h3>Method</h3><p>This was a secondary cross-sectional analysis of data obtained in a cohort study (Brazilian RibeirãoPreto and São Luís Birth Cohort Studies - BRISA), whose deliveries were performed between 2010 and 2011. Standardized questionnaires were applied to mothers, and placentas and newborns were evaluated shortly after delivery. Placental efficiency was assessed using the ratio between birth weight and placental weight (BW/PW ratio); values below the lower quartile (25th percentile for gestational age) were considered to have low placental efficiency. Newborn phenotypes were small and large for gestational age, stunted and wasted, evaluated using the INTERGROWTH-21 growth standard. To identify the confounding variables theoretical model was constructed using Directed Acyclic Graphs, and unadjusted and adjusted logistic regression were performed. Placental measurements were obtained blindly from pregnancy and delivery data.</p></div><div><h3>Results</h3><p>723 mother-placenta-child triads were studied. 3.2 % of newborns were small-for-gestational-age (SGA), 6.5 %large-for-gestational-age (LGA), 5.7 %had stunting, and 0.27 % wasting. A significantly higher risk was found between low placental efficiency and SGA (OR 2.82;95 % CI 1.05–7.57), stunting (OR 2.23; 95 % CI 1.07–4.65), and wasting (OR 8.22; 95 % CI 1.96–34.37). No relationship was found between LGA and placental efficiency.</p></div><div><h3>Conclusions</h3><p>Low placental efficiency was associated with increased risk for small-for-gestational-age, stunting, and wasting. Placental morphometry can provide valuable information on intrauterine conditions and neonatal health, helping to identify newborns at higher risk of future comorbidities.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S002175572400007X/pdfft?md5=ea300f6ebcc88118299e8bc444152477&pid=1-s2.0-S002175572400007X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139722714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a diagnostic prediction model for severe periventricular-intraventricular hemorrhage in newborns: insights from a retrospective analysis utilizing the MIMIC-III database","authors":"Zhiyue Deng ,&nbsp;Jiaxin Tang ,&nbsp;Chengzhi Fang ,&nbsp;Bing-Hong Zhang","doi":"10.1016/j.jped.2023.12.004","DOIUrl":"10.1016/j.jped.2023.12.004","url":null,"abstract":"<div><h3>Objective</h3><p>Periventricular-intraventricular hemorrhage is the most common type of intracranial bleeding in newborns, especially in the first 3 days after birth. Severe periventricular-intraventricular hemorrhage is considered a progression from mild periventricular-intraventricular hemorrhage and is often closely associated with severe neurological sequelae. However, no specific indicators are available to predict the progression from mild to severe periventricular-intraventricular in early admission. This study aims to establish an early diagnostic prediction model for severe PIVH.</p></div><div><h3>Method</h3><p>This study was a retrospective cohort study with data collected from the MIMIC-III (v1.4) database. Laboratory and clinical data collected within the first 24 h of NICU admission have been used as variables for both univariate and multivariate logistic regression analyses to construct a nomogram-based early prediction model for severe periventricular-intraventricular hemorrhage and subsequently validated.</p></div><div><h3>Results</h3><p>A predictive model was established and represented by a nomogram, it comprised three variables: output, lowest platelet count and use of vasoactive drugs within 24 h of NICU admission. The model's predictive performance showed by the calculated area under the curve was 0.792, indicating good discriminatory power. The calibration plot demonstrated good calibration between observed and predicted outcomes, and the Hosmer-Lemeshow test showed high consistency (<em>p</em> = 0.990). Internal validation showed the calculated area under a curve of 0.788.</p></div><div><h3>Conclusions</h3><p>This severe PIVH predictive model, established by three easily obtainable indicators within the NICU, demonstrated good predictive ability. It offered a more user-friendly and convenient option for neonatologists.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755724000020/pdfft?md5=1338c8ce37460e3917443e77e1693e01&pid=1-s2.0-S0021755724000020-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139717463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fasting glucose: a cardiometabolic indicator for subclinical atherosclerosis on excess weight adolescents","authors":"Camila M. Medeiros,&nbsp;Carla C.M. Medeiros,&nbsp;Ricardo A. Olinda,&nbsp;Rodrigo P.T. Vianna,&nbsp;Monica O.S. Simões,&nbsp;Marília M. Medeiros,&nbsp;Danielle F. de Carvalho","doi":"10.1016/j.jped.2023.11.010","DOIUrl":"10.1016/j.jped.2023.11.010","url":null,"abstract":"<div><h3>Objective</h3><p>To build a model based on cardiometabolic indicators that allow the identification of overweight adolescents at higher risk of subclinical atherosclerotic disease (SAD).</p></div><div><h3>Methods</h3><p>Cross-sectional study involving 161 adolescents with a body mass index ≥ +1 z-Score, aged 10 to 19 years. Carotid intima-media complex thickness (IMT) was evaluated using ultrasound to assess subclinical atherosclerotic disease. Cardiometabolic indicators evaluated included nutritional status, central adiposity, blood pressure, lipidic profile, glycemic profile, as well as age and sex. Data was presented using measures of central tendency and dispersion, as well as absolute and relative frequency. The relationship between IMT measurement (outcome variable) and other variables (independent variables) was assessed using Pearson or Spearman correlation, followed by multiple regression modeling with Gamma distribution to analyze predictors of IMT. Statistical analysis was performed using SPSS and R software, considering a significance level of 5 %.</p></div><div><h3>Results</h3><p>It was observed that 23.7 % had Carotid thickening, and the prevalence of abnormal fasting glucose was the lowest. Age and fasting glucose were identified as predictors of IMT increase, with IMT decreasing with age by approximately 1 % per year and increasing with glucose by around 0.24 % per mg/dL.</p></div><div><h3>Conclusion</h3><p>The adolescent at higher risk is younger with higher fasting glycemia levels.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755724000056/pdfft?md5=08ab236faf06e8156d0b5243bc504fb2&pid=1-s2.0-S0021755724000056-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing delayed detection of isolated cleft palate-related deformity: a call for routine intraoral examination of newborns","authors":"Rafael Denadai ,&nbsp;Lun-Jou Lo","doi":"10.1016/j.jped.2023.12.005","DOIUrl":"10.1016/j.jped.2023.12.005","url":null,"abstract":"<div><h3>Objective</h3><p>To provide healthcare professional-friendly practical recommendations for early detection of cleft palate-related deformities in newborns and offer an overview of managing these high-prevalent congenital abnormalities.</p></div><div><h3>Source of data</h3><p>PubMed, SciELO, Lilacs, Cochrane, ScienceDirect, and Scopus databases were reviewed for cleft- and diagnosis-related studies.</p></div><div><h3>Summary of the findings</h3><p>Unfortunately, the global prevalence of delayed detection of cleft palate-related deformities remains unacceptably high, with over a quarter of cleft palates missed at birth. This delayed identification causes physical and psychological distress for patients and families, including feeding challenges and weight faltering. To improve cleft management, it is essential to adopt routine detailed, in-depth intraoral examination immediately after birth. It is recommended not only to finger-assisted palpate the intraoral structures but also to visually inspect the oral cavity from gingiva to uvula using a wooden tongue depressor and light-assisted examination. With timely diagnosis and referral to specialized care, pediatricians, nurses, speech therapists, and plastic surgeons provide life-changing treatments, including health care maintenance, anticipatory guidance, feeding support, primary surgical reconstruction, and age- and condition-specific protocols.</p></div><div><h3>Conclusions</h3><p>Encouraging neonatologists and pediatricians, who are the first to examine newborns, to actively investigate the intraoral region for cleft palate-related deformities is instrumental in optimizing therapeutic approaches and prioritizing age-phases in treatment. Their crucial role in early detection and referral can lead to transformative outcomes, impacting not only the future of the newborns by facilitating functional integration into society but also yielding positive effects on families and the health system.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755724000044/pdfft?md5=ce49d5eccc66ecdc73b8881972ce40b6&pid=1-s2.0-S0021755724000044-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139646613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Missed opportunities in the prevention and diagnosis of pediatric tuberculosis: a scoping review","authors":"Daniela Otoni Russo ,&nbsp;Ana Luisa Lodi Jimenez ,&nbsp;Lilian Martins Oliveira Diniz ,&nbsp;Claudete Araújo Cardoso ,&nbsp;Roberta Maia de Castro Romanelli","doi":"10.1016/j.jped.2023.10.009","DOIUrl":"10.1016/j.jped.2023.10.009","url":null,"abstract":"<div><h3>Objectives</h3><p>Identify potential barriers, delays, and missed opportunities in the prevention and diagnosis of childhood TB.</p></div><div><h3>Methods</h3><p>Scoping review according to the PRISMA extension. The definitions considered for the selection followed the acronym PCC where the population (P) is children under 18 years of age with TB disease, the concept (C) refers to missed opportunities for prevention and diagnosis, and context (C) is defined as a diagnosis of TB disease. The authors searched systematically in the databases; VHL/Lilacs, Medline via PubMed, Cochrane, Scopus, and Web of Science, without date or language limitation.</p></div><div><h3>Results</h3><p>Seven studies were included. In developed countries, with low disease burden, the main shortcoming is the delay in diagnosing bacilliferous adults in contact with young children. This problem is concentrated in the portion of the population with socioeconomic vulnerability. In underdeveloped countries, with a high burden of disease, the biggest challenge is tracking children who come into contact with bacilliferous patients.</p></div><div><h3>Conclusions</h3><p>There are still many missed opportunities in the prevention and diagnosis of childhood TB. The positive legacy of the COVID-19 pandemic should be taken advantage of and the encouragement of scientific development in the management of infectious diseases should be taken.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755724000068/pdfft?md5=000c0ebc56c28229781407966a84bcdd&pid=1-s2.0-S0021755724000068-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139646223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical strategies in pediatric tracheobronchomalacia: tailoring solutions by understanding the problem","authors":"Benjamin Zendejas","doi":"10.1016/j.jped.2024.01.002","DOIUrl":"10.1016/j.jped.2024.01.002","url":null,"abstract":"","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755724000032/pdfft?md5=b3b9f882481b66f81a3edcbf90cff34d&pid=1-s2.0-S0021755724000032-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139580166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment for severe pediatric tracheobronchomalacia: the 20-year experience of a single center","authors":"Caroline Gargioni Barreto ,&nbsp;Marcelo Costamilan Rombaldi ,&nbsp;Felipe Colombo de Holanda ,&nbsp;Iara Siqueira Lucena ,&nbsp;Paola Maria Santis Isolan ,&nbsp;Russell Jennings ,&nbsp;José Carlos Fraga","doi":"10.1016/j.jped.2023.10.008","DOIUrl":"10.1016/j.jped.2023.10.008","url":null,"abstract":"<div><h3>Objective</h3><p>In children with tracheobronchomalacia, surgical management should be reserved for the most severe cases and be specific to the type and location of tracheobronchomalacia. The goal of this study is to describe the presentation and outcomes of children with severe tracheobronchomalacia undergoing surgery.</p></div><div><h3>Methods</h3><p>Retrospective case series of 20 children operated for severe tracheobronchomalacia at a tertiary hospital from 2003 to 2023. Data were collected on symptoms age at diagnosis, associated comorbidities, previous surgery, age at surgery, operative approach, time of follow-up, and outcome. Surgical success was defined as symptom improvement.</p></div><div><h3>Results</h3><p>The most frequent symptoms of severe tracheobronchomalacia were stridor (50 %), cyanosis (50 %), and recurrent respiratory infections (45 %). All patients had one or more underlying conditions, most commonly esophageal atresia (40 %) and prematurity (35 %). Bronchoscopy were performed in all patients. Based on etiology, patients underwent the following procedures: anterior aortopexy (<em>n</em> = 15/75 %), posterior tracheopexy (<em>n</em> = 4/20 %), and/or posterior descending aortopexy (<em>n</em> = 4/20 %). Three patients underwent anterior aortopexy and posterior tracheopexy procedures. After a median follow-up of 12 months, 16 patients (80 %) had improvement in respiratory symptoms. Decannulation was achieved in three (37.5 %) out of eight patients with previous tracheotomy. The presence of dying spells at diagnosis was associated with surgical failure.</p></div><div><h3>Conclusions</h3><p>Isolated or combined surgical procedures improved respiratory symptoms in 80 % of children with severe tracheobronchomalacia. The choice of procedure should be individualized and guided by etiology: anterior aortopexy for anterior compression, posterior tracheopexy for membranous intrusion, and posterior descending aortopexy for left bronchus obstruction.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755723001572/pdfft?md5=fd7c9263792d8e7c82b32784a0c65c50&pid=1-s2.0-S0021755723001572-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139558264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prediction model for coronary artery abnormalities in children with Kawasaki disease older than 5 years","authors":"Penghui Yang,&nbsp;Jing Zhang,&nbsp;Zhuo Chen,&nbsp;Qijian Yi","doi":"10.1016/j.jped.2023.12.002","DOIUrl":"10.1016/j.jped.2023.12.002","url":null,"abstract":"<div><h3>Objective</h3><p>Reliably prediction models for coronary artery abnormalities (CAA) in children aged &gt;5 years with Kawasaki disease (KD) are still lacking. This study aimed to develop a nomogram model for predicting CAA at 4 to 8 weeks of illness in children with KD older than 5 years.</p></div><div><h3>Methods</h3><p>A total of 644 eligible children were randomly assigned to a training cohort (n = 450) and a validation cohort (n = 194). The least absolute shrinkage and selection operator (LASSO) analysis was used for optimal predictors selection, and multivariate logistic regression was used to develop a nomogram model based on the selected predictors. Area under the receiver operating characteristic curve (AUC), calibration curves, Hosmer-Lemeshow test, Brier score, and decision curve analysis (DCA) were used to assess model performance.</p></div><div><h3>Results</h3><p>Neutrophil to lymphocyte ratio, intravenous immunoglobulin resistance, and maximum baseline z-score ≥ 2.5 were identified by LASSO as significant predictors. The model incorporating these variables showed good discrimination and calibration capacities in both training and validation cohorts. The AUC of the training cohort and validation cohort were 0.854 and 0.850, respectively. The DCA confirmed the clinical usefulness of the nomogram model.</p></div><div><h3>Conclusions</h3><p>A novel nomogram model was established to accurately assess the risk of CAA at 4–8 weeks of onset among KD children older than 5 years, which may aid clinical decision-making.</p></div>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021755723001584/pdfft?md5=561ccbf1975f0a42fd0fdb3ee2edcb8c&pid=1-s2.0-S0021755723001584-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139084385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}