Abstract: Objective To construct a Nomogram prediction model for recurrent wheezing after bronchiolitis,providing more scientific prevention and clinical decision-making guidance for children with recurrent wheezing in clinical practice.Methods Hospitalized pediatric patients diagnosed with bronchiolitis at Linqu County People′s Hospital from January 2022 to December 2022 were selected as the study subjects.Clinical data and related indicators such as FeNO were collected.After discharge,patients were followed up for one year.According to whether recurrent wheezing occurred during the follow-up period,they were divided into an observation group(recurrent wheezing occurred) and a control group(no recurrent wheezing occurred).The two sets of parameters were screened for meaningful variables through Lasso regression and univariate logistic regression analysis,and multivariate logistic regression analysis was included to establish a Nomogram prediction model for recurrent wheezing after bronchiolitis.Use the Hosmer Lemeshow goodness of fit test to calculate the C-index and the area under the receiver operating characteristic curve(AUC) to evaluate the accuracy of the model.The clinical application value of the nomogram was assessed by using decision curves.ResultsA  total of 85 pediatric patients were included in this study,17 in the observation group and 68 in the control group.In general data analysis,it was found that there were intergroup differences in FeNO(P=0.048) and lymphocyte count(P=0.023).Include single factor logistic regression analysis and Lasso regression analysis separately.After adjusting for age and gender,univariate logistic regression found that the differences in FeNO(OR=1.242,95%CI (1.002,1.541)，P=0.048) and lymphocyte count (OR=1.428,95%CI (1.028,1.985)，P=0.034) were statistically significant;Lasso regression analysis showed that the λ of minimum mean square error was 0.042,and the corresponding model variables were FeNO and lymphocyte count.After establishing a Nomogram model for predicting recurrent wheezing in bronchiolitis using a multiple factor logistic regression equation,the Hosmer Lemeshow test chi square value was 3.881,P=0.868,C-index was 0.706,and the AUC of FeNO and lymphocyte count was 0.654 and 0.674,respectively,indicating that the scoring model worked well.The decision curve analysis found that the model=repeated wheezing-FeNO+lymphocyte count had good clinical application value.Conclusion The Nomogram prediction model for recurrent wheezing after bronchiolitis established through FeNO and lymphocyte count has good clinical application value.

Key words:

Bronchiolitis, Fractional exhaled nitric oxide(FeNO), Recurrent wheezing, Prediction model, Child