Supplementary file 1_Clinical value of neutrophil-to-lymphocyte ratio and D-dimer in predicting the efficacy of minocycline for pediatric Mycoplasma pneumoniae pneumonia.pdf

Baseline NLR and D-dimer levels, along with other laboratory indicators obtained prior to treatment, were compared between the two groups to evaluate their predictive value for treatment outcome. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed.</p>Results<p>The non-responsive group exhibited significantly higher NLR (median 2.62 vs. 1.69, P < 0.001) and D-dimer levels (median 0.36 vs. 0.18 mg/L, P < 0.001) compared to the responsive group.

Multivariate logistic regression identified NLR (OR=2.113, 95% CI: 1.184–3.770, P = 0.011) and D-dimer (OR = 148.867, 95% CI: 4.994–4438.007, P = 0.004) as independent risk factors for poor treatment response. ROC analysis demonstrated that the area under the curve (AUC) for the combined detection of NLR and D-dimer was 0.858 (95% CI: 0.756–0.926), which was superior to NLR (AUC=0.773) or D-dimer (AUC=0.776) alone. Optimal cut-off values were determined as 1.904 for NLR (sensitivity 82.9%, specificity 76.7%) and 0.175 mg/L for D-dimer (sensitivity 94.3%, specificity 89.5%).

Furthermore, both NLR and D-dimer were positively correlated with the length of hospital stay (r = 0.383 and r = 0.477, respectively, P < 0.001).</p>Conclusion<p>NLR and D-dimer are reliable and accessible biomarkers for predicting early clinical response to minocycline in pediatric MPP. Elevated baseline levels identify patients at risk for persistent fever and need for treatment escalation. Their combined detection offers high clinical value, facilitating early identification of poor responders and timely adjustment of therapeutic strategies.</p>