Full
Outline
To identify risk factors for secondary fungal infection in patients with pneumoconiosis complicated by bacterial pneumonia and to develop a nomogram prediction model.
Clinical data of patients admitted to a tertiary occupational disease hospital between December 2021 and July 2024 were retrospectively analyzed and randomly divided into training and testing sets (7:3). Variables were selected using LASSO and multivariable logistic regression to construct a nomogram. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA).
Among 641 patients, 213 developed secondary pulmonary fungal infection. Multivariable analysis showed that invasive procedures (OR=3.440, 95% CI:2.111-5.699), elevated immature granulocyte percentage (OR=2.294, 95% CI:1.254-4.402), systemic glucocorticoid use (OR=2.196, 95% CI:1.114-4.327), repeated hospitalization (OR=2.094, 95% CI:1.280-3.464), and increasing age (OR=1.059, 95% CI:1.034-1.085) were associated with increased risk, whereas higher large platelet count was associated with reduced risk (OR=0.980, 95% CI:0.968-0.992). The nomogram achieved AUCs of 0.818 (95% CI:0.777-0.858) in the training set and 0.797 (95% CI:0.688-0.906) in the testing set. Calibration and DCA demonstrated good agreement and clinical net benefit.
The nomogram accurately predicts secondary fungal infection risk in this population, demonstrating favorable performance and potential for early risk stratification and targeted intervention.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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