Establishment of early high-risk disease prediction model for preschool children with acute upper respiratory tract infection and febrile convulsion

Objective To analyze the influencing factors of early condition changes in preschool children with acute upper respiratory tract infection and febrile convulsion, and to establish a high-risk disease prediction model.

Methods A total of 384 preschool children with convulsion after high fever of acute upper respiratory tract infection in our hospital from January 2019 to June 2021 were selected as research objects. Based on the early warning scoring system (PEWS), the children were divided into low-risk group(n=294), medium-risk group(n=65) and high-risk group(n=25). Univariate comparison and multiple ordered Logistic regression analysis were used to determine the influencing factors of early condition of preschool children with acute upper respiratory tract infection and febrile convulsion, binary Logistic regression analysis was used to determine the high-risk influencing factors of early condition of preschool children with acute upper respiratory tract infection and febrile convulsion; ROC curve was used to analyze the prediction efficiency of high-risk influencing factors of early condition. The nomogram of high-risk disease changes was drawn based on the results of binary Logsitic regression.

Results Multiple ordered Logistic regression analysis showed that age, convulsions, disordered respiratory rhythm, blurred consciousness, Br, NLR, RDW and average body temperature after the first convulsion were the influencing factors of the changes of early conditions of preschool children with febrile convulsion caused by acute upper respiratory tract infection (P < 0.05). Binary Logistic regression analysis showed that age over five years old, convulsion, respiratory rhythm disorder, confusion of consciousness, Br, NLR, RDW and average body temperature(>40.0 to 41.0 ℃ and >39.0 to 40.0 ℃) after the first convulsion were the high-risk factors of early condition in preschool children with acute upper respiratory tract infection and febrile convulsion (P < 0.05). ROC curve analysis showed that age (>5 yeas old), convulsion, respiratory rhythm disorder, confusion of consciousness, breath rate (BR), neutrophil to lymphocyte ratio (RDW), red cell distribution width (NLR) and high average temperature of the body after the first convulsion had better predictive effects on the early high-risk changes of children with febrile convulsion (P < 0.05). The nomogram showed the predicted score of the high-risk condition prediction model for preschool children with acute upper respiratory tract infection and high fever convulsion was from 85 to 287 points, which can effectively evaluate the risk rate from 0.1% to 95.0%.

Conclusion The early condition changes of preschool children with acute upper respiratory tract infection and febrile convulsion may be affected by factors such as convulsion, respiratory rhythm disorder, complicating with confusion of consciousness, BR, NLR, RDW and average body temperature after the first convulsion. Corresponding intervention measures should be taken for preschool children with acute upper respiratory tract infection and febrile convulsion to prevent their early condition deterioration.