ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Pulmonology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1638103
Risk Factors for Airway Clearance Dysfunction in Children with Severe Pneumonia: A Retrospective Study of LASSO Model
Provisionally accepted
- Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central Hospital, Nanchong, China
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Background: This study aimed to investigate the types and risk factors of airway clearance dysfunction (ACD) in children with severe pneumonia based on LASSO regression and multivariate Logistic regression analysis. Results: A total of 63 cases of ACD were observed among children with severe pneumonia, including ineffective coughing, thick sputum, dyspnea, nasal flaring/ increased nasal congestion, tachypnea, and oxygen saturation <93%, with an incidence rate of 42.86%. Significant differences were found between the ACD group and non-ACD group in terms of age, mechanical ventilation, nutritional status, comorbid respiratory failure, comorbid heart failure, pulmonary rales, and pulmonary rhonchi (P < 0.05). Additionally, the ACD group had lower platelet count (PLT), immunoglobulin A (IgA), and immunoglobulin M (IgM) levels, while C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) levels were higher compared to the non-ACD group (P < 0.05). Variable screening was performed using the LASSO regression model, identifying three significant influencing factors. These were incorporated into a Logistic regression model, which revealed that mechanical ventilation, CRP, PCT, IL-6, and IgA were influencing factors for ACD in children with severe pneumonia. Based on these findings, an ROC curve was constructed, demonstrating that the combined prediction of mechanical ventilation, CRP, PCT, IL-6, and IgA for ACD in children with severe pneumonia achieved an AUC of 0.882, significantly higher than the AUC of any single indicator (P < 0.05). Conclusion: Children with severe pneumonia are at risk of developing ACD, which may be influenced by mechanical ventilation, CRP, PCT, IL-6, and IgA levels. These five factors can be used to assess the risk of ACD in children with severe pneumonia. Accordingly, clinical measures should be developed to improve airway clearance ability and promote recovery in these patients.
Keywords: children with severe pneumonia, airway clearance dysfunction, mechanical ventilation, C-Reactive Protein, Ineffective cough
Received: 30 May 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Ding, Bai and Liu. 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: Xiaoyan Ding, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central Hospital, Nanchong, China
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