Clinical features and risk factors of adenovirus-related plastic bronchitis in children

To analyze the clinical characteristics of children with adenoviral pneumonia, identify independent risk factors for early prediction of plastic bronchiolitis (PB), and develop a predictive nomogram. This retrospective study analyzed the clinical data of children diagnosed with adenoviral pneumonia. Patients were categorized into PB and non-PB groups. General characteristics, clinical symptoms, laboratory findings, and imaging results were compared between the two groups. Multivariate logistic regression was used to identify significant risk factors, and a nomogram model was constructed. Among the 164 patients, 139 were in the non-PB group and 25 were in the PB group. Multivariate logistic regression identified diminished breath sounds, D-dimer (D-D) levels, and Lactic dehydrogenase (LDH) levels as significant risk factors for PB. The nomogram developed from these factors had an area under the receiver operating characteristic curve (AUC) of 0.904 (95% confidence interval: 0.847-0.960). The Hosmer-Lemeshow test showed good calibration (p = 0.515, X2 = 7.207). Diminished breath sounds, D-D levels, and LDH levels are independent risk factors for PB in children with adenoviral pneumonia. The developed nomogram demonstrates high predictive accuracy and good calibration, providing a valuable tool for early prediction and clinical decision-making. Future studies should validate this nomogram in larger and diverse populations.