A nomogram prediction model for plastic bronchitis in children with refractory Mycoplasma pneumoniae pneumonia

Objective To determine the risk factors for plastic bronchitis (PB) in children diagnosed with Mycoplasma Pneumoniae Pneumonia (RMPP) and facilitate early intervention. Methods A retrospective study of 205 hospitalized children diagnosed with RMPP in two tertiary hospitals was conducted from January 2023 to May 2025. The children were divided into the PB group and non-PB group. Clinical characteristics, laboratory indices, pulmonary imaging findings, and treatment approaches were compared between the two groups. A nomogram model was established based on logistic regression to assess the risk of PB in children infected with RMPP. Results A total of 52 patients (25.4%) were included in the PB group. The nomogram model constructed in this study indicated that three risk factors- C-reactive protein (CRP) > 20 mg/L, pleural effusion, and high Lactate Dehydrogenase (LDH) levels- could be used for the early identification of PB in children with RMPP. The area under the receiver operating characteristic curve of the prediction model was 0.783 (95%CI: 0.71–0.86). The Hosmer–Lemeshow goodness-of-fit test demonstrated the good calibration of the nomogram [( P = 0.408, R 2 = 8.269)]. Decision curve analysis showed that the model had clinical value. Conclusions Early identification of these risk factors (CRP > 20 mg/L, pleural effusion, and elevated LDH) may facilitate timely bronchoscopic examination in children with RMPP at high risk of PB, potentially contributing to improved clinical management.