ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Pulmonology
Age-Stratified Selection of Albumin-Based Inflammatory Ratios: A Novel Strategy for Optimizing Risk Prediction of Severe Pneumonia in Children
Provisionally accepted
- Fuyang Women's and Children's Hospital, Fuyang, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: This study aimed to optimize risk prediction of severe community-acquired pneumonia (CAP) in children through age-stratified selection of albumin-based inflammatory ratios. Methods: This retrospective study analyzed 1,071 pediatric CAP patients (aged 1-12 years). Propensity score matching (1: 2 severe-to-mild ratio) within three age strata (1-3y, 4-6y, 7-12y) generated balanced cohorts (N=360). Neutrophil percentage-to-albumin ratio (NPAR), C-reactive protein-to-albumin ratio (CAR), and CRP×lymphocyte-to-albumin ratio (CALLY) were evaluated using multivariate logistic regression and ROC analysis. Results: Severe CAP incidence increased with age (1–3y: 7.37%; 4–6y: 12.80%; 7–12y: 18.04%). Multivariate analysis identified NPAR as the sole independent predictor for younger children (1–3y: OR = 10.289; 4–6y: OR = 35.117), while CAR predicted severe CAP in older children (7–12y: OR = 3.342). ROC analysis demonstrated robust performance for NPAR in 1–6y (AUC 0.748–0.807, NPV 85.9–88.0%) and CAR in 7–12y (AUC 0.734, NPV 83.0%). Conclusions: NPAR (for ages 1–6 years) and CAR (for ages 7–12 years) serve as effective, age-specific biomarkers for severe CAP, facilitating precise risk stratification with high negative predictive value.
Keywords: Community-acquired pneumonia, albumin ratios, Age stratification, NPAR, CAR, Negative predictive value
Received: 05 Aug 2025; Accepted: 29 Oct 2025.
Copyright: © 2025 Bai, Zhang and Hou. 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: Changxu Hou, fylyhcx123@sina.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.