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World Journal of Pediatrics

Open Access 13-04-2024 | Vasovagal Syncope | Original Article

Age and mean platelet volume-based nomogram for predicting the therapeutic efficacy of metoprolol in Chinese pediatric patients with vasovagal syncope

Authors: Xiao-Juan Du, Ya-Qian Huang, Xue-Ying Li, Ying Liao, Hong-Fang Jin, Jun-Bao Du

Published in: World Journal of Pediatrics

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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.
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Metadata
Title
Age and mean platelet volume-based nomogram for predicting the therapeutic efficacy of metoprolol in Chinese pediatric patients with vasovagal syncope
Authors
Xiao-Juan Du
Ya-Qian Huang
Xue-Ying Li
Ying Liao
Hong-Fang Jin
Jun-Bao Du
Publication date
13-04-2024
Publisher
Springer Nature Singapore
Published in
World Journal of Pediatrics
Print ISSN: 1708-8569
Electronic ISSN: 1867-0687
DOI
https://doi.org/10.1007/s12519-024-00802-5