Relevant factors for developing loculation after parapneumonic pleural effusion in children

Abstract

Objective To identify the relevant factors for the loculation clinically in children with parapneumonic pleural effusion(PPE). Methods The clinical data of 172 children with PPE were retrospectively reviewed from January 2012 to March 2015 in Children's Hospital of Hebei Province.Based on the findings of chest ultrasound, the subjects were divided into 2 groups, the loculation group(78 cases) and the control group(94 cases). The comparison was made between the 2 groups in gender, age, course of disease and fever before admitting into hospital, the location of the effusion, white blood cells(WBC) and the percentage of neutrophils(N), blood platelet(PLT), lactate dehydrogenase(LDH), C-reactive protein(CRP), mycoplasma(MP), the routine and biochemical examination of pleural fluid, including white cell count(WBCp), the percentage of polymorphonuclear cell(PMN), lactate dehydrogenase(LDHp), glucose(GLU), adenosine deaminase(ADA), lactic acid(LAC) and C-reactive protein(CRPp). If the result of single factor regression showed P<0.01, the indicators were analyzed by the multifactor Logistic regression.The receiver operator characteristic(ROC) curve was drawn to evaluate the prediction ability of Logistic regression models. Results (1)The result of single factor regression indicated that the risk factors included age, WBC, PLT, LDH, MP, WBCp, PMN, GLU and LAC(all P<0.05).(2)The result of multifactor Logistic regression showed that the factors included PLT(OR=3.437, P=0.007), LDH(OR=0.306, P=0.006), GLU(OR=0.324, P=0.037), MP(OR=0.375, P=0.022)and LAC(OR=3.656, P=0.003).(3)The area under the ROC curve was 0.876, P= 0.000, which indicated that the regression models had over medium diagnostic accuracy. Conclusions When PLT>434.5×109/L, LDH 3.83 mmol/L, it may indicate that the formation of loculation for the PPE children. Key words: Parapneumonic pleural effusion; Loculation; Relevant factors; Logistic regression analysis; Child