A nomogram prediction model for plastic bronchitis in children with refractory Mycoplasma pneumoniae pneumonia
Hongcai He1, Ziyang Kuang2, Zhongfa Zhang1
1Department of Pediatrics, The Third Affiliated Hospital of Chengdu Medical College, People's Hospital of Pi County, Chengdu, Sichuan, China.
Insights
Early identification of plastic bronchitis (PB) in children with Mycoplasma Pneumoniae Pneumonia (RMPP) is possible. Key risk factors include elevated C-reactive protein (CRP), pleural effusion, and high Lactate Dehydrogenase (LDH) levels.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Medical Diagnostics
Background:
- Plastic bronchitis (PB) is a rare but serious condition.
- Mycoplasma Pneumoniae Pneumonia (RMPP) is a common pediatric respiratory infection.
- Identifying risk factors for PB in RMPP is crucial for timely intervention.
Purpose of the Study:
- To determine risk factors for developing plastic bronchitis (PB) in children diagnosed with Mycoplasma Pneumoniae Pneumonia (RMPP).
- To facilitate early detection and intervention for PB in pediatric RMPP patients.
- To develop a predictive model for PB risk in RMPP.
Main Methods:
- Retrospective study of 205 hospitalized children with RMPP.
- Comparison of clinical, laboratory, and imaging findings between PB and non-PB groups.
- Development of a nomogram model using logistic regression to predict PB risk.
Main Results:
- 52 patients (25.4%) were diagnosed with PB.
- Key predictors for PB included C-reactive protein (CRP) > 20 mg/L, pleural effusion, and elevated Lactate Dehydrogenase (LDH) levels.
- The predictive model demonstrated good accuracy (AUC = 0.783) and clinical utility.
Conclusions:
- Elevated CRP, pleural effusion, and high LDH are significant risk factors for PB in children with RMPP.
- Early identification of these risk factors can guide timely bronchoscopic examination.
- This approach may improve clinical management and outcomes for pediatric RMPP patients at risk of PB.
Objective:
To determine the risk factors for plastic bronchitis (PB) in children diagnosed with Mycoplasma Pneumoniae Pneumonia (RMPP) and facilitate early intervention.
Methods:
A retrospective study of 205 hospitalized children diagnosed with RMPP in two tertiary hospitals was conducted from January 2023 to May 2025. The children were divided into the PB group and non-PB group. Clinical characteristics, laboratory indices, pulmonary imaging findings, and treatment approaches were compared between the two groups. A nomogram model was established based on logistic regression to assess the risk of PB in children infected with RMPP.
Results:
A total of 52 patients (25.4%) were included in the PB group. The nomogram model constructed in this study indicated that three risk factors- C-reactive protein (CRP) > 20 mg/L, pleural effusion, and high Lactate Dehydrogenase (LDH) levels- could be used for the early identification of PB in children with RMPP. The area under the receiver operating characteristic curve of the prediction model was 0.783 (95%CI: 0.71-0.86). The Hosmer-Lemeshow goodness-of-fit test demonstrated the good calibration of the nomogram [(P = 0.408, R2 = 8.269)]. Decision curve analysis showed that the model had clinical value.
Conclusions:
Early identification of these risk factors (CRP > 20 mg/L, pleural effusion, and elevated LDH) may facilitate timely bronchoscopic examination in children with RMPP at high risk of PB, potentially contributing to improved clinical management.
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