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Clinical features and risk factors of adenovirus-related plastic bronchitis in children

Yifan Wang1,2, Yuhan Jiang1,2, Ruiwen Xia1,2

  • 1Clinical School of Paediatrics, Tianjin Medical University, Tianjin, China.

Italian Journal of Pediatrics
|April 27, 2025
PubMed

Insights

Early prediction of plastic bronchiolitis (PB) in children with adenoviral pneumonia is possible. Diminished breath sounds, D-dimer, and LDH levels are key risk factors, aiding clinical decision-making.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Clinical Prediction Modeling

Background:

  • Adenoviral pneumonia is a common respiratory infection in children.
  • Plastic bronchiolitis (PB) is a severe complication that can arise from adenoviral pneumonia.
  • Early identification of children at risk for PB is crucial for timely intervention.

Purpose of the Study:

  • To analyze clinical features of pediatric adenoviral pneumonia.
  • To identify independent risk factors for predicting plastic bronchiolitis (PB).
  • To develop and validate a predictive nomogram for PB in children.

Main Methods:

  • Retrospective analysis of clinical data from 164 children with adenoviral pneumonia.
  • Comparison of clinical characteristics, symptoms, lab findings, and imaging between PB and non-PB groups.
  • Multivariate logistic regression and nomogram construction to identify risk factors and predict PB.

Main Results:

  • Multivariate analysis identified diminished breath sounds, elevated D-dimer (D-D) levels, and increased Lactic dehydrogenase (LDH) levels as significant risk factors for PB.
  • The developed nomogram achieved an AUC of 0.904, indicating high predictive accuracy.
  • The nomogram demonstrated good calibration, suggesting reliable predictions.

Conclusions:

  • Diminished breath sounds, D-D, and LDH levels are independent predictors of PB in pediatric adenoviral pneumonia.
  • The validated nomogram serves as a valuable tool for early PB prediction and clinical management.
  • Further validation in larger, diverse populations is recommended to confirm the nomogram's utility.
Abstract

Keywords:
Adenoviral pneumoniaFiberoptic bronchoscopyNomogram modelPlastic bronchitisRisk factors

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