ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Pulmonology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1564217
Association between Gustave Roussy Immune Score and delay in discharge among children and adolescents with mycoplasma pneumoniae pneumonia: a retrospective cohort study
Provisionally accepted
- 1Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
- 2Shandong University of Traditional Chinese Medicine, Jinan, China
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Background: Mycoplasma pneumoniae pneumonia (MPP) is one of the leading causes of hospitalization and death in children. Epidemiological studies have confirmed that single blood indicators such as neutrophil to lymphocyte ratio (NLR), lactic dehydrogenase (LDH) and albumin (Alb) levels are associated with the prognosis and length of stay (LOS) of MPP patients. We aim to evaluate the association of the GRIm-score with LOS and compare its strength of association with that of its individuals components. Methods: We recruited 786 children with MPP who were admitted to the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from 2014 to 2021. The end of follow-up was discharge. The univariate and multivariate logistics regression models were conducted to explore the association between NLR, LDH, Alb as well as GRIm-score with LOS among our cohort, with odd ratios (ORs) and 95% confidence intervals (CIs). Receiver operating characteristic (ROC) curve, net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were used to compare the predictive efficacy of GRIm-score with NLR, LDH and in predicting the LOS among MPP children and adolescents. Results: After the inclusion and exclusion process, 389 eligible children and adolescents with MPP were included, with the mean age of 5.21 (±2.59 years). After adjusted covariates, we found LDH and GRIm-score were positivity associated with the LOS (LDH: β=0.40, 95%CI: 0.00-0.80; GRIm-score: β=0.33, 95%CI: 0.07-0.58). High GRIm-score was associated with LOS ≥7 days or 11 days (≥7 days: OR=0.635, 95%CI: 0.585-0.685; ≥11 days: OR=0.622, 95%CI: 0.543-0.700). Area under curve (AUC), NRI and IDI all shown GRIm-score had excellent efficacy in predicting the LOS of children with MPP compared with single indicators such as LDH, NLR and Alb. Conclusion: The GRIm-score showed a significant associated with the prolonged LOS in children with MPP, and the strength of this association is higher than its individual components. These findings still need to be confirmed by further large multicenter prospective cohort studies.
Keywords: Gustave Roussy immune score, Neutrophil to lymphocyte ratio, Lactic dehydrogenase, albumin, Mycoplasma pneumoniae pneumonia, Length of Stay
Received: 21 Jan 2025; Accepted: 15 Sep 2025.
Copyright: © 2025 Zhou, Zhang, Li and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xingyou Zhao, xingyou_zhao@163.com
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