Age and mean platelet volume-based nomogram for predicting the therapeutic efficacy of metoprolol in Chinese pediatric patients with vasovagal syncope.
World J Pediatr
; 20(9): 957-965, 2024 Sep.
Article
in En
| MEDLINE
| ID: mdl-38613734
ABSTRACT
BACKGROUND:
Vasovagal syncope (VVS) is the most common type of orthostatic intolerance in children. We investigated whether platelet-related factors related to treatment efficacy in children suffering from VVS treated with metoprolol.METHODS:
Metoprolol-treated VVS patients were recruited. The median duration of therapy was three months. Patients were followed and divided into two groups, treament-effective group and treatment-ineffective group. Logistic and least absolute shrinkage selection operator regressions were used to examine treatment outcome variables. Receiver-operating characteristic (ROC) curves, precision-recall (PR) curves, calibration plots, and decision curve analyses were used to evaluate the nomogram model.RESULTS:
Among the 72 patients who complete the follow-up, treatment-effective group and treatment-ineffective group included 42 (58.3%) and 30 (41.7%) cases, respectively. The patients in the treatment-effective group exhibited higher mean platelet volume (MPV) [(11.0 ± 1.0) fl vs. (9.8 ± 1.0) fl, P < 0.01] and platelet distribution width [12.7% (12.3%, 14.3%) vs. 11.3% (10.2%, 12.2%), P < 0.01] than those in the treatment-ineffective group. The sex ratio was significantly different (P = 0.046). A fit model comprising age [odds ratio (OR) = 0.766, 95% confidence interval (CI) = 0.594-0.987] and MPV (OR = 5.613, 95% CI = 2.297-13.711) might predict therapeutic efficacy. The area under the curve of the ROC and PR curves was computed to be 0.85 and 0.9, respectively. The P value of the Hosmer-Lemeshow test was 0.27. The decision curve analysis confirmed that managing children with VVS based on the predictive model led to a net advantage ranging from 0.01 to 0.58. The nomogram is convenient for clinical applications.CONCLUSION:
A novel nomogram based on age and MPV can predict the therapeutic benefits of metoprolol in children with VVS.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Syncope, Vasovagal
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Nomograms
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Mean Platelet Volume
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Metoprolol
Limits:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Male
Country/Region as subject:
Asia
Language:
En
Journal:
World J Pediatr
/
World j. pediatr
/
World journal of pediatrics
Journal subject:
PEDIATRIA
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: