Influencing factors of multiple bronchoscopic lavage therapy in Mycoplasma pneumoniaepneumonia and construction of prediction model

Objective To analyze the influencing factors of Mycoplasma pneumoniae pneumonia (MPP) child patients receiving multiple bronchoscopic lavage therapy and construct a prediction model. Methods A total of 203 MPP children who underwent bronchoscopic lavage therapy in the Affiliated Hospital of Xuzhou Medical University from June 2018 to June 2020 were enrolled and their clinical data were retrospectively analyzed. According to the times of bronchoscopic lavage therapy, they were divided into two groups: a single lavage group (n=150) and a multiple lavage group (n=53). Both groups were compared for the differences in general information, clinical symptoms, laboratory examination, and complications. Then, the risk factors of multiple lavage for treatment of MPP were analyzed, so as to construct a prediction model. Results According to univariate analysis, there were no significant differences in sex, age, other infections, the number of lung lobes involved in inflammation, onset seasons, white blood cell counts and creative kinase isoenzyme level (P>0.05). In the two groups, pleural effusion, extrapulmonary complications, fever before admission, duration of cough, the maximal body temperature before admission, the mean body temperature after admission of Days 1—3 (Tmean), the use of macrolide antibiotics≥5 days before admission, fibrinogen degradation products, D-dimers, C-reactive protein, alanine aminotransferase (ALT), serum albumin (ALB), serum prealbumin, lactate dehydrogenase indexes were statistically different (P<0.05). Furthermore, multivariate logistic regression analysis showed that increases in Tmean, D-dimers and ALT, and decreases in ALB were risk factors influencing the times of bronchoscopic lavage therapy, with a predictive accuracy of 90.6%. According to multivariate regression analysis, the area under the curve of joint predictors was 0.885, and the cutoff value was 34.885, the sensitivity was 0.837, and the specificity was 0.851. Conclusions Bronchoscopy lavage is an effective method for the treatment of MPP. Early identification of risk factors that may require multiple lavage treatment is of positive significance for rational communication between doctors and patients and improvement of prognosis.