Development of a nomogram for severe influenza in previously healthy children: a retrospective cohort study

Abstract

Objective We aimed to develop a nomogram to predict the risk of severe influenza in previously healthy children. Methods In this retrospective cohort study, we reviewed the clinical data of 1135 previously healthy children infected with influenza who were hospitalized in the Children's Hospital of Soochow University between 1 January 2017 and 30 June 2021. Children were randomly assigned in a 7:3 ratio to a training or validation cohort. In the training cohort, univariate and multivariate logistic regression analyses were used to identify risk factors, and a nomogram was established. The validation cohort was used to evaluate the predictive ability of the model. Result Wheezing rales, neutrophils, procalcitonin > 0.25 ng/mL, Mycoplasma pneumoniae infection, fever, and albumin were selected as predictors. The areas under the curve were 0.725 (95% CI: 0.686–0.765) and 0.721 (95% CI: 0.659–0.784) for the training and validation cohorts, respectively. The calibration curve showed that the nomogram was well calibrated. Conclusion The nomogram may predict the risk of severe influenza in previously healthy children.