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Association of complete blood count parameters with adverse outcomes in acute pediatric pneumonia

Lin Han1,2, Ying Yang1, Yanhao Huang1

  • 1Department of Respiratory Medicine Children's Hospital of Chongqing Medical University, National Clinical Research Center for Children and Adolescents' Health and Diseases, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Chongqing, China.

Pediatric Research
|May 29, 2026
PubMed

Insights

Complete blood count parameters like neutrophil-to-lymphocyte ratio (NLR) and hemoglobin (Hb) can predict adverse outcomes in pediatric pneumonia. These accessible biomarkers aid in rapid risk assessment, especially in resource-limited settings.

Area of Science:

  • Pediatric Medicine
  • Hematology
  • Clinical Diagnostics

Background:

  • Pediatric pneumonia is a major global cause of mortality in children under five.
  • Complete blood count (CBC) parameters show potential as early indicators of clinical deterioration.
  • Identifying cost-effective biomarkers for adverse outcome prediction in pediatric pneumonia is crucial for primary care settings.

Purpose of the Study:

  • To identify reliable and accessible biomarkers for predicting adverse outcomes in pediatric pneumonia.
  • To evaluate the predictive performance of seven CBC parameters in pediatric pneumonia cases.
  • To assess the utility of CBC parameters for risk stratification in resource-limited settings.

Main Methods:

  • Retrospective case-control study of 15,359 pediatric pneumonia admissions (2015-2022).
  • Analysis of seven CBC parameters: hemoglobin (Hb), platelet (PLT), neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), absolute neutrophil count (ANC), lymphocyte absolute value (LYM), and white blood cell count (WBC).
  • Utilized restricted cubic splines, multivariable logistic regression, and ROC curve analysis to correlate CBC parameters with adverse outcomes.

Main Results:

  • Severe pediatric pneumonia cases showed reduced Hb, PLT, and LYM, with elevated RDW, ANC, and NLR.
  • Multivariable analysis identified Hb and PLT as negative predictors, and NLR and RDW as positive predictors of adverse outcomes.
  • Neutrophil-to-lymphocyte ratio (NLR) exhibited the strongest predictive performance, followed by Hb; their combination further improved prediction.

Conclusions:

  • Complete blood count parameters, particularly NLR and Hb, are robust predictors of adverse outcomes in pediatric pneumonia.
  • These readily available and low-cost indices can be integrated into risk stratification protocols.
  • The findings offer a practical tool for rapid triage and clinical decision-making in primary and resource-limited care settings.
Abstract

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