Analysis of risk factors for plastic bronchitis induced by Streptococcus pneumoniae in children

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OBJECTIVE: To explore the clinical characteristics and independent risk factors of pneumococcal pneumonia complicated with plastic bronchitis. METHODS: 156 patients with pneumococcal pneumonia who were admitted to the Department of Pediatrics of the First Affiliated Hospital of Xinxiang Medical University. The patients were divided into plastic bronchitis (PB) group and non-plastic bronchitis (non-PB) group. PB patients were further divided into complication group (EC) and non-complication group (non-EC). The Mann-Whitney U test or chi-square test was used to compare the differences between the groups. The ROC curve was drawn to evaluate the accuracy of independent risk factors in predicting PB. RESULTS: There were significant differences in the positive rate of pulmonary consolidation in different lobes (χ2 = 20.01, P = 0.0005), among which the probability of consolidation in the right lower lung was significantly higher than that in the other four lobes (P < 0.05). Bronchoscopy showed that the PB group was more serious than the non-PB group in terms of mucosal erythema (P = 0.02) and color of secretion(P < 0.01). The extrapulmonary complications were more common (P < 0.05). Multivariate analysis showed that mucosal erythema, secretion color and PCT were independent risk factors for PB (P < 0.05). ROC curve analysis showed that mucosal erythema, secretion volume, secretion color and PCT had a certain predictive value for PB, with AUCs of 0.7, 0.77, 0.71 and 0.61, respectively. CONCLUSION: The amount of secretion, mucosal erythema, secretion color (yellow-white) and PCT are independent risk factors for plastic bronchitis and have high value in its prediction.