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Utility of a Combined Diagnostic and Severity Scoring System Based on Complete Blood Count and Derived
Quan Liu1, Li Wei1, Liang Wang1
1Department of Medical Laboratory, Huaibei People's Hospital (Huaibei People's Hospital Attached to Bengbu Medical University), Huaibei, People's Republic of China.
Background:
This study assessed the diagnostic value of complete blood count (CBC) and derived immune-inflammatory indicators for Mycoplasma pneumoniae pneumonia (MPP) in children and developed a practical scoring system for early diagnosis.
Methods:
A total of 1662 MP-infected children were divided into pneumonia (n = 844) and non-pneumonia (n = 818) groups. CBC parameters, derived immune-inflammatory indicators and C-reactive protein (CRP) were compared. Diagnostic performance was assessed using ROC curve analysis, and diagnostic models were constructed using multivariate logistic regression. Age-stratified analysis addressed confounding. Model stability was evaluated via repeated stratified 10-fold cross-validation, calibration curves with Brier score, and decision curve analysis (DCA). A simplified scoring system was established and validated for clinical application.
Results:
Children in the pneumonia group were significantly younger (mean age 5.78 ± 3.41 years vs. 8.62 ± 4.92 years, p < 0.001). Lymphocyte count (LYM), lymphocyte percentage (LYM%), platelet count (PLT), plateletcrit (PCT), and the product of absolute lymphocyte count and platelet count (PLT × LYM) in the pneumonia group were significantly higher than in the non-pneumonia group. Age-stratified analysis confirmed these differences across all age subgroups (all p < 0.001). PLT × LYM, LYM%, PLT, and PCT were independent predictors. Internal validation showed a mean AUC of 0.7824 ± 0.0353, good calibration (Brier score = 0.1918 ± 0.0164), and positive net benefit on DCA. The scoring system achieved diagnostic rates of 71.5%, 51.2%, and 29.6% for high-, medium-, and low-risk groups, respectively.
Conclusion:
MPP predominantly affects children under 7 years old. The simple scoring system, supported by robust internal validation, effectively stratifies pneumonia risk and offers a practical early diagnostic tool for primary care.
Insights
Mycoplasma pneumoniae pneumonia (MPP) primarily affects young children. A new scoring system using complete blood count (CBC) indicators aids early diagnosis and risk stratification in pediatric MPP.
Area of Science:
- Pediatric infectious diseases
- Hematology
- Diagnostic biomarkers
Background:
- Mycoplasma pneumoniae pneumonia (MPP) is a common childhood infection.
- Early and accurate diagnosis of MPP is crucial for effective management.
- Complete blood count (CBC) and derived inflammatory markers may aid in MPP diagnosis.
Purpose of the Study:
- To evaluate the diagnostic utility of CBC and derived immune-inflammatory indicators for MPP in children.
- To develop and validate a practical scoring system for early MPP diagnosis.
Main Methods:
- Retrospective analysis of 1662 MP-infected children (pneumonia vs. non-pneumonia groups).
- Comparison of CBC parameters, immune-inflammatory indicators, and C-reactive protein (CRP).
- Development and validation of a scoring system using logistic regression, ROC analysis, and cross-validation.
Main Results:
- Pneumonia group was significantly younger (mean age 5.78 years).
- Elevated Lymphocyte count (LYM), LYM%, Platelet count (PLT), Plateletcrit (PCT), and PLT × LYM product observed in the pneumonia group.
- The scoring system demonstrated good diagnostic performance (AUC 0.7824) and risk stratification capabilities.
Conclusions:
- MPP predominantly affects children under 7 years.
- A simple, validated scoring system using CBC parameters can aid in early MPP diagnosis and risk stratification.
- This tool is practical for primary care settings.
