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Comparison of a new predictive model with other critical scores for predicting in-hospital mortality among children with pneumonia-related bacteremia
  1. Jilei Lin1,
  2. Yin Zhang1,
  3. Anchao Song2,
  4. Nan Yang1,
  5. Linyan Ying1,
  6. Jihong Dai1
  1. 1Department of Respiratory Disease, Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders. Chongqing Key Laboratory of Pediatrics, Chongqing, China
  2. 2School of Public Health and Management, Chongqing Medical University, Chongqing, China
  1. Correspondence to Professor Jihong Dai, Department of Respiratory Disease, Chongqing Medical University Affiliated Children's Hospital, Chongqing 400014, China; 328776694{at}qq.com

Abstract

Prediction of mortality in children with pneumonia-related bacteremia is necessary for providing timely care and treatment. This study aims to develop and validate a nomogram and compare it with Pediatric Risk of Mortality III (PRISM III), Brighton Pediatric Early Warning Score (Brighton PEWS) and Pediatric Critical Illness Score (PCIS), which are widely used in predicting in-hospital mortality in children with pneumonia-related bacteremia. This retrospective study collected clinical data of hospitalized children with pneumonia-related bacteremia in Chongqing, China (January 2013–May 2019). The nomogram was built using multivariate logistic regression analysis. The nomogram was compared with PRISM III, PEWS and PCIS in accuracy and clinical benefits in predicting in-hospital mortality in children with pneumonia-related bacteremia. A total of 242 children were included. The nomogram including time to first positivity of blood cultures (TTFP), serum albumin (ALB) and lactate dehydrogenase (LDH) was established. The area under the receiver operating characteristic curve of the nomogram was 0.84 (95% CI 0.77 to 0.91) in the training set and 0.82 (95% CI 0.71 to 0.93) in the validating set. Good consistency was observed between the predictions and the actual observations, and the decision curve analysis showed that the nomogram was clinically useful. The results showed that the nomogram significantly performed better than the three critical scores. In conclusion, a nomogram-illustrated model incorporating TTFP, ALB and LDH for predicting in-hospital mortality in children with pneumonia-related bacteremia at the early stage was established and validated. It performed better than PRISM III, PEWS and PCIS.

  • bacteria
  • critical care
  • prognosis
  • respiratory tract diseases

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

  • Contributors Conceptualization: JL, JD and YZ. Methodology: JL, JD and YZ. Validation: YZ and JL. Formal analysis: JL and AS. Investigation: LY and NY. Data curation: LY and NY. Writing–original draft preparation: JL and YZ. Writing–review and editing: JD.

  • Funding The study was funded by the Youth Program of the National Natural Science Foundation of China (no. 81700017).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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