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Dynamic Changes of De Ritis Ratio in Pediatric Lobar Pneumonia and Their Relationship With Disease Severity

Rong Li1, Shanshan Chen1, Qianqian Yang1

  • 1Department of Pediatrics, The Affiliated Hospital of Xuzhou Medical University, 221000 Xuzhou, Jiangsu, China.

British Journal of Hospital Medicine (London, England : 2005)
|January 29, 2026
PubMed

Insights

The De Ritis ratio effectively assesses lobar pneumonia (LP) severity in children. Dynamic changes in this ratio correlate with disease progression, aiding in clinical management.

Area of Science:

  • Pediatric Medicine
  • Biomarkers
  • Infectious Diseases

Background:

  • Lobar pneumonia (LP) is a major cause of childhood illness.
  • Accurate severity assessment is vital for managing pediatric LP.
  • Specific biomarkers for LP severity are currently limited.

Purpose of the Study:

  • To investigate dynamic changes in the aspartate aminotransferase/alanine aminotransferase (De Ritis) ratio in pediatric LP.
  • To explore the relationship between the De Ritis ratio and LP disease severity.
  • To evaluate the diagnostic efficacy of the De Ritis ratio for LP in children.

Main Methods:

  • 120 children with LP were classified into common (n=69) and severe (n=51) groups.
  • Hierarchical multiple linear regression analyzed factors influencing the De Ritis ratio.
  • Receiver operating characteristic (ROC) curve and clinical decision curve analyses assessed diagnostic utility.

Main Results:

  • The De Ritis ratio showed significant changes over time and between severity groups (p < 0.001).
  • The decline in De Ritis ratio (ΔDe Ritis ratio) was greater in severe LP cases.
  • The De Ritis ratio demonstrated high diagnostic efficacy (AUC=0.908) with a cutoff of 1.52.

Conclusions:

  • The De Ritis ratio is a valuable biomarker for evaluating pediatric LP.
  • Dynamic alterations in the De Ritis ratio correlate with disease severity.
  • This ratio offers significant clinical utility in diagnosing and managing pediatric LP.
Abstract

Keywords:
alanine aminotransferaseaspartate aminotransferasechildrendisease severitylobar pneumonia

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