Developing a Nomogram for Predicting Risk of Invasive Mechanical Ventilation in Children With Severe Adenovirus Associated Pneumonia

Background: The recognition of the development of poor outcomes in children with HAdV infection in early stage of the disease is vital because of high mortality rates. This study aimed to develop and validate a nomogram in predicting risk of IMV in children with SAdVP at the early stage of the disease.Methods: The retrospective study collected clinical data of hospitalized children with SAdVP in general wards of a 1900-bed teaching hospital in Chongqing, China (2015-2019). The nomogram was built by using the multivariate logistic regression analysis. The performance of the nomogram was assessed by discrimination, calibration and clinical utility. Results: Two hundred and seven children with SAdVP were included. Age, level of albumin, atelectasis and creatine kinase MB isoenzyme were identified as predictors in the nomogram. The area under the receiver operating characteristic curve of the nomogram was 0.85 (95% CI, 0.78-0.91) in the training set and 0.81 (95% CI, 0.69-0.94) in the validating set. A good consistency was observed between the predictions and the actual observations, and decision curve analysis showed that the nomogram was clinically useful. Conclusions: Nomogram to predict the risk of IMV in children with SAdVP in general wards was established and validated. It may be a valuable tool for clinicians to recognize the risk of IMV for children with SAdVP at the early stage of the disease.