AUTHOR=Yang Fan , Dong Ruirui , Wang Yating , Guo Junshuang , Zang Qiuling , Wen Lijun , Huang Peipei , Qin Jinjin , Song Dandan , Ren Zhiping , Teng Junfang , Miao Wang 

TITLE=Prediction of pulmonary infection in patients with severe myelitis by NPAR combined with spinal cord lesion segments

JOURNAL=Frontiers in Neurology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1364108

DOI=10.3389/fneur.2024.1364108

ISSN=1664-2295

ABSTRACT=Objectives: To investigate the risk factors of pulmonary infection in patients with severe myelitis and construct a prediction model.The clinical data of 177 patients with severe myelitis at admission from the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2022 were retrospectively analyzed. The predicting factors associated with pulmonary infection were screened by multivariate logistic regression analysis, and the nomogram model was constructed, and the predictive efficiency of the model was evaluated, which was verified by calibration curve, Hosmer-Lemeshow goodness-of-fit test and decision curve analysis.Of the 177 patients with severe myelitis, 38(21.5%) had pulmonary infection.Multivariate logistic regression analysis showed that neutrophil percentage to albumin Ratio (NPAR) (OR=6.865,95%CI:1.746-26.993, P=0.006) and high cervical cord lesion (OR=2.788,95%CI:1.229-6.323, P=0.014) were independent risk factors for pulmonary infection, and the combined nomogram could easily predict the occurrence of lung infection, with a C-index of 0.766 (95% CI: 0.678-0.854). The calibration curve, Hosmer-Lemeshow goodness-of-fit test (  2=9.539, P=0.299) and decision curve analysis showed that the model had good consistency and clinical applicability.The nomogram model constructed based on NPAR combined with high cervical cord lesion at admission has good clinical application value in predicting pulmonary infection in patients with severe myelitis, which is conducive to clinicians' evaluation of patients.This study retrospectively collected the clinical data of patients with severe myelitis from January 2020 to December 2022 in the First Affiliated Hospital of Zhengzhou University. Myelitis in this study included three types: acute myelitis, acute transverse myelitis and acute non-transverse myelitis. All patients met the diagnostic criteria for myelitis and were diagnosed by experienced neurologists. Inclusion criteria were: (1) meeting the diagnostic criteria for acute myelitis(15); (2) critically ill patients [Expanded Disability Status Scale (EDSS) score≥6.0]. Exclusion criteria were: (1) admission with concurrent infections (37 patients); (2) Age <18 years (21 patients); (3) concomitant severe liver or kidney dysfunction (1 patients); (4)