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Author Spotlight: Investigating the Key Factors of Obliterative Bronchiolitis After Lung Transplantation
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Author Spotlight: Investigating the Key Factors of Obliterative Bronchiolitis After Lung Transplantation

Published on: November 10, 2023

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Risk factors and prediction models for bronchiolitis obliterans after severe adenoviral pneumonia

Shunhang Wen1, Ming Xu1, Weigang Jin1

  • 1Department of Children's Respiration Disease, the Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, 109 West Xueyuan Road, Lucheng District, Wenzhou, 325000, Zhejiang, People's Republic of China.

European Journal of Pediatrics
|December 20, 2023
PubMed

Insights

Children under 1 year, PICU admission, prolonged fever, and bilateral lung infections are key risk factors for developing post-infectious bronchiolitis obliterans (PIBO) after severe adenoviral pneumonia (SAP). A predictive nomogram aids early PIBO diagnosis and intervention.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases

Background:

  • Adenoviruses are primary causes of post-infectious bronchiolitis obliterans (PIBO).
  • Risk factors for PIBO include wheezing, tachypnea, hypoxemia, and mechanical ventilation.

Purpose of the Study:

  • Investigate risk factors for PIBO in children with severe adenoviral pneumonia (SAP).
  • Develop and validate a predictive nomogram for PIBO in pediatric SAP patients.

Main Methods:

  • Prospective study of 148 hospitalized children with SAP.
  • Least Absolute Shrinkage and Selection Operator (LASSO) regression for variable selection.
  • Logistic regression and nomogram construction for risk factor analysis and prediction.

Main Results:

  • Age < 1 year, PICU admission, long fever duration, and bilateral lung infection identified as significant risk factors for PIBO.
  • The developed nomogram demonstrated strong predictive accuracy with a C-index of 0.85.
  • The nomogram showed good calibration and clinical utility via decision curve analysis.

Conclusions:

  • Age < 1 year, PICU admission, prolonged fever, and bilateral lung infection are independent predictors of PIBO in pediatric SAP.
  • The nomogram serves as a valuable tool for early PIBO diagnosis and timely clinical intervention.

Keywords:
ChildrenHuman adenovirusNomogramPneumoniaPost-infectious bronchiolitis obliterans

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