Initial presentation, etiology and risk factors for adverse outcomes in infection-associated plastic bronchitis in children: a retrospective study
Abstract
Objective: To summarize the pathogen distribution, imaging features, radiologic outcomes, and risk factors for poor prognosis in children with infection-associated plastic bronchitis (PB).
Methods: This retrospective study included 86 hospitalized children diagnosed with infection-associated PB at Henan Children's Hospital from January 2021 to December 2023. Patients were grouped based on radiologic findings and outcomes into favorable prognosis, poor prognosis, and indeterminate outcome groups. Clinical data and laboratory results were compared between the favorable and poor prognosis groups to identify potential risk factors for adverse outcomes.
Results: Among 86 children with infection-associated PB, 81 (94.2%) were caused by Mycoplasma pneumoniae (MP), including 29 (35.8%) co-infections. Of the MP-associated cases, 65 (80.2%) showed a good outcome, and 10 (12.3%) had unclear outcomes, while 6 (7.4%) developed adverse outcomes. These included 1 case requiring surgery, 3 with persistent atelectasis, 1 with both atelectasis and bronchiectasis, and 1 with persistent bronchiectasis. Patients with adverse outcomes exhibited significantly higher levels of LDH (788.5 U/L vs. 408 U/L, p = 0.01) and D-dimer (2.20 μg/mL vs. 0.81 μg/mL, p = 0.01) compared to the good-outcome group. The adverse-outcome group also required more bronchoscopic interventions (median 3.5 vs. 2, p p = 0.01), and more frequent use of low molecular weight heparin (100% vs. 21.5%, p p = 0.02).
Conclusion:…
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