Analysis of risk factors for the development of bronchiolitis obliterans in children with severe Mycoplasma pneumoniae pneumonia.

BACKGROUND

Bronchiolitis obliterans is a chronic obstructive lung disease characterized by irreversible airway damage, which leads to a poor prognosis. At present, there are relatively few studies on the risk factors for bronchiolitis obliterans caused by Mycoplasma pneumoniae in children. We investigated the clinical manifestations and risk factors for the development of bronchiolitis obliterans in children with severe Mycoplasma pneumoniae pneumonia with the aim of early intervention and improved prognosis.

METHODS

This study retrospectively analyzed 35 children with severe Mycoplasma pneumoniae who developed bronchiolitis obliterans hospitalized at the Children's Hospital Affiliated with Zhengzhou University from January 2022 to November 2023 as the study subjects. In addition, 137 children with severe Mycoplasma pneumoniae did not develop bronchiolitis obliterans during the same period as the control group. We performed a multivariate logistic regression analysis of the clinical data of the two groups of patients to determine the independent risk factors for the development of bronchiolitis obliterans in children with pneumonia.

RESULTS

The age of the children in the bronchiolitis obliterans group was 52 (21, 83) months, the male to female ratio was 3:2, and the number of days of hospitalization was 11 (7, 15) days. The results of multivariate logistic regression analysis revealed that younger age (in months), the combination of viral infections, and the presence of the three-concave sign, pulmonary atelectasis, and bronchiectasis were independent risk factors for the development of bronchiolitis obliterans in children with severe Mycoplasma pneumoniae. The predictive value of the results of the multivariate logistic regression analysis for the area under the ROC curve assessment showed an AUC = 0.859 (95% CI, 0.788-0.931).

CONCLUSION

The risk of bronchiolitis obliterans is greater in children with severe Mycoplasma pneumoniae at a younger age, with combined viral infections, and with manifestations such as the three-concave sign, pulmonary atelectasis, and bronchiectasis, and we should be vigilant for bronchiolitis obliterans so that early diagnosis can be made and timely intervention can be performed to treat the disease.