Application of Clinical Indicators in the Early Prediction of Refractory Mycoplasma pneumoniae Pneumonia in Children: A Retrospective Study

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This study aims to compare the clinical characteristics of children with general Mycoplasma pneumoniae pneumonia (GMPP) and refractory Mycoplasma pneumoniae pneumonia (RMPP), identify predictive factors for RMPP, and construct a predictive nomogram for early clinical prediction of RMPP. This retrospective study included 223 children with Mycoplasma pneumoniae pneumonia admitted to Lishui District People’s Hospital in Nanjing from June 2023 to February 2024. Children were divided into GMPP (171 cases) and RMPP (52 cases) based on treatment response. Baseline characteristics, laboratory findings, and imaging results were compared between groups. Multivariate logistic regression and receiver operating characteristic curve analysis were used to identify and evaluate predictive factors for RMPP. The RMPP group had higher incidence of dyspnea, lung consolidation, atelectasis, and pleural effusion, and longer hospital stays. Laboratory tests showed elevated C-reactive protein, interleukin-6 (IL-6), D-dimer, and lactate dehydrogenase (LDH) levels in RMPP compared with GMPP. Multivariate analysis identified LDH, IL-6, and D-dimer as significant predictive factors for RMPP. The combined model’s area under the curve was 0.946, indicating high prediction efficacy. Elevated levels of LDH, IL-6, and D-dimer are associated with RMPP. The predictive nomogram based on these markers improves RMPP risk assessment, providing a scientific basis for early recognition and personalized treatment.