Analysis of Clinical Characteristics and Construction of Risk Nomogram Model for Hand,Foot and Mouth Disease in Children
10.11969/j.issn.1673-548X.2024.05.021
- VernacularTitle:儿童手足口病临床特征分析及风险列线图模型构建
- Author:
Xiuhui LI
1
;
Sijing PAN
;
Yuting SUN
Author Information
1. 030001 太原,山西医科大学流行病学教研室
- Keywords:
Hand,foot and mouth disease;
Children;
Clinical characteristics;
Nomogram
- From:
Journal of Medical Research
2024;53(5):102-107
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical characteristics of children with hand,foot and mouth disease(HFMD)infected with different enterovirus subtypes and construct a risk nomogram prediction model to provide basis for HFMD prevention and treatment.Meth-ods The clinical data of 346 cases of children hospitalized with HFMD in Shanxi Children's Hospital(Shanxi Maternal and Child Health Hospital)from 2017-2021 were collected and divided into Coxsackie virus A16 group(n=26),enterovirus 71 group(n=56)and en-terovirus general group(n=264)according to different enteroviruses,and the clinical characteristics were compared between the three groups to construct a risk nomogram model in children with HFMD combined with brainstem encephalitis to validate the prediction effect of the model.Results The age of children with HFMD was mainly distributed between 1 and 3 years(81.21％),with a male to female ra-tio of 1.56∶1,with a primary peak of incidence in June to August and a secondary peak in October to November,with enterovirus 71 type infections predominating in 2017 and enterovirus general infections in 2018-2021.The differences were statistically significant in age,days of hospitalization,presence of fever,fever typing,days of fever duration,herpes,maculopapular rash,oral rash,knee rash,white blood cell,platelet count,C-reactive protein and procalcitonin among the three groups(P＜0.05).The occurrence of HFMD combined with brainstem encephalitis in children was positively correlated with longer days of hospitalization and fever duration,papular rash and en-terovirus 71 positivity,and negatively correlated with longer days of rash(P＜0.05).The nomogram model showed that the probability of occurrence of childhood HFMD combined with brainstem encephalitis was 85.6％,the area under the receiver operating characteristic curve was 0.860.The calibration curve showed that the actual probability was in good agreement with the predicted probability,and the decision curve showed that the net gain of the model essentially to the full threshold probability was obvious.Conclusion HFMD in chil-dren has obvious seasonality with double peaks,enterovirus general type is the dominant pathogen of HFMD in recent years,the clinical characteristics of infection with different enteroviruses are different,the risk nomogram model has good early prediction effect on HFMD combined with brainstem encephalitis in children,and has high clinical application value,which is important for the prevention,diagnosis and treatment of HFMD in children.
