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Background <p><i>Mycoplasma pneumoniae</i> pneumonia (MPP) can impose substantial healthcare burden in children. Because retrospective severity definitions can be heterogeneous, we used total hospitalization cost as a complementary high–resource-use phenotype and aimed to identify admission-time predictors of high cost and develop an early prediction model.</p> Methods <p>We retrospectively enrolled 402 hospitalized children with MPP at Shantou Central Hospital, China (Jan–Dec 2024). A Gaussian mixture model (GMM) was fitted to total hospitalization cost to derive a data-driven threshold for a high-cost (high–resource-use) subgroup. Using variables available within the first 24&#xa0;h of admission, we developed a logistic model including age, Tmax, lactate dehydrogenase (LDH), and radiographic consolidation, and then evaluated an age × consolidation interaction. Discrimination was assessed by ROC AUC; age-stratified analyses were used to interpret joint age–consolidation patterns.</p> Results <p>A data-driven cost threshold identified a high-cost subgroup (&gt; 7,139 RMB; 41/402, 10.2%), defined a posteriori from the observed hospitalization-cost distribution. High-cost cases had longer length of stay, more frequent intensive management (bronchoalveolar lavage and systemic corticosteroids), and a higher prevalence of consolidation. The four-variable model showed good discrimination (AUC 0.790), which improved after adding the age × consolidation interaction (AUC 0.838). Inflammatory markers were higher in consolidation-positive patients, with the largest differences observed in younger children; correspondingly, the interaction model identified younger children with consolidation as having the highest predicted high-cost risk.</p> Conclusions <p>In this single-center retrospective cohort, hospitalization cost operationalized a high–resource-use phenotype in pediatric MPP. An admission-time model incorporating an age × consolidation interaction may support early risk stratification and resource planning in similar settings; external validation is needed before clinical use.</p>

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Independent risk factors and predictive model for high hospitalization costs in children with Mycoplasma pneumoniae pneumonia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月10日

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  • Xianyao Wang,
  • Hachao Zhou,
  • Lingling Jiang,
  • Haipeng Lin,
  • Wenshan Zhong,
  • Ruiling Ma,
  • Zhiwei Xiao,
  • Shaofen Lin,
  • Jing Lin,
  • Yutao Guo,
  • Mingxiang Lin

摘要

Background

Mycoplasma pneumoniae pneumonia (MPP) can impose substantial healthcare burden in children. Because retrospective severity definitions can be heterogeneous, we used total hospitalization cost as a complementary high–resource-use phenotype and aimed to identify admission-time predictors of high cost and develop an early prediction model.

Methods

We retrospectively enrolled 402 hospitalized children with MPP at Shantou Central Hospital, China (Jan–Dec 2024). A Gaussian mixture model (GMM) was fitted to total hospitalization cost to derive a data-driven threshold for a high-cost (high–resource-use) subgroup. Using variables available within the first 24 h of admission, we developed a logistic model including age, Tmax, lactate dehydrogenase (LDH), and radiographic consolidation, and then evaluated an age × consolidation interaction. Discrimination was assessed by ROC AUC; age-stratified analyses were used to interpret joint age–consolidation patterns.

Results

A data-driven cost threshold identified a high-cost subgroup (> 7,139 RMB; 41/402, 10.2%), defined a posteriori from the observed hospitalization-cost distribution. High-cost cases had longer length of stay, more frequent intensive management (bronchoalveolar lavage and systemic corticosteroids), and a higher prevalence of consolidation. The four-variable model showed good discrimination (AUC 0.790), which improved after adding the age × consolidation interaction (AUC 0.838). Inflammatory markers were higher in consolidation-positive patients, with the largest differences observed in younger children; correspondingly, the interaction model identified younger children with consolidation as having the highest predicted high-cost risk.

Conclusions

In this single-center retrospective cohort, hospitalization cost operationalized a high–resource-use phenotype in pediatric MPP. An admission-time model incorporating an age × consolidation interaction may support early risk stratification and resource planning in similar settings; external validation is needed before clinical use.