Abstract: Objective To analyze the influencing factors for disease severity in pediatric obstructive sleep apnea-hypopnea syndrome(OSAHS)and assess their clinical predictive value. Methods A total of 182 children with OSAHS treated at Shijiazhuang People's Hospital from January 2023 to December 2024 were enrolled. Demographic information, polysomnography data, and complete blood count results were collected, and systemic inflammatory indicators were calculated. Differences between groups, Spearman rank correlation, random forest model, and logistic regression analysis were used to identify factors influencing disease severity in children with OSAHS, and a prediction model was constructed based on these factors. The predictive performance was evaluated using the receiver operating characteristic(ROC)curve. Results Statistically significant differences were observed in body mass index(BMI), history of premature birth, and systemic inflammatory indicators between children with mild OSAHS and those with moderate to severe OSAHS(P<0.05). Spearman rank correlation and random forest model analysis revealed that the neutrophil-to-lymphocyte ratio(NLR)was the most influential variable among the six systemic inflammatory indicators affecting disease severity. Logistic regression analysis showed that higher BMI(OR=1.383, 95%CI: 1.201-1.592)and higher NLR(OR=1.575, 95%CI: 1.262-1.965)were associated with an increased risk of moderate to severe OSAHS(P<0.05). ROC curve analysis demonstrated that the constructed prediction model achieved an area under the curve of 0.800(95%CI: 0.734-0.856)for predicting disease severity. Conclusion BMI and NLR are influencing factors for disease severity in children with OSAHS. The prediction model based on these two factors demonstrates good predictive performance, which may facilitate early assessment of disease severity and guide clinical management.

Key words: Obstructive sleep apnea hypopnea syndrome, Disease severity, Systemic inflammation indicator, Body mass index, Prediction model