A Decade-Long Real-World Cohort (2016-2025): Development of an Individualized Risk-Stratification Nomogram and Evaluation of Clinical Utility for Recurrent Respiratory Tract Infections in Children - Report - MDSpire
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A Decade-Long Real-World Cohort (2016-2025): Development of an Individualized Risk-Stratification Nomogram and Evaluation of Clinical Utility for Recurrent Respiratory Tract Infections in Children
Clinical Report: Personalized Risk-Stratification for Pediatric RRTIs
Overview
This ten-year study (2016-2025) developed a nomogram to predict recurrent respiratory tract infections (RRTIs) in a cohort of 6,026 children, identifying key risk factors. The tool demonstrated robust predictive performance and potential clinical utility for early risk stratification.
Background
Recurrent respiratory tract infections (RRTIs) significantly impact pediatric health, leading to increased healthcare costs and diminished quality of life. Identifying high-risk children through effective risk assessment tools can facilitate targeted prevention strategies. This study addresses the need for individualized approaches to manage RRTIs in pediatric populations.
Data Highlights
Variable
Odds Ratio (OR)
P-value
History of allergy
5.187
<0.001
History of asthma
2.522
<0.001
Lower vitamin A level
0.458 per 0.1 mg/L increase
<0.001
Lower vitamin D level
0.556 per 10 ng/mL increase
<0.001
Lower birth weight
0.283 per kg increase
<0.001
Passive smoking exposure
2.061
<0.001
Lower hemoglobin level
0.425 per 10 g/L increase
<0.001
Key Findings
The study included 6,026 children, with 20.4% developing RRTIs.
Independent predictors of RRTIs included history of allergy, asthma, and nutritional indicators.
The nomogram showed good discrimination and calibration in both training (n=4,219; events=859) and testing sets (n=1,807; events=368).
Decision-curve analysis indicated favorable net benefits for clinical utility.
Risk stratification effectively categorized children into low-, intermediate-, and high-risk groups.
Clinical Implications
The developed nomogram can aid clinicians in identifying children at high risk for RRTIs, allowing for early intervention and tailored preventive measures. This tool leverages routinely available clinical and nutritional data, enhancing decision-making in pediatric practice and potentially integrating into existing clinical workflows.
Conclusion
The nomogram represents a significant advancement in the risk stratification of pediatric RRTIs, with the potential to improve clinical outcomes through targeted prevention strategies, aligning with current literature on pediatric respiratory health.
