Fig. 3: Classification and regression tree (CART) analysis showing treatment choices among three main immunomodulatory modalities: IVIG+MP, IVIG+MP + Anakinra, and IVIG+MP + Anakinra+TPE.
From: Multisystem Inflammatory Syndrome in Children with tailored therapy and six-month outcome
“Y” (Yes) and “N” (No) indicate whether the preceding clinical criterion was met (e.g., respiratory support: Y = required, N = not required). Each node represents a clinical criterion guiding treatment, determined through binary recursive partitioning. Laboratory cut-off values for CRP (>12.65 mg/dL) and ferritin (>1107 µg/L) were determined automatically by the CART algorithm, as described in the Methods, to maximize separation between treatment groups. Bars show the number of patients receiving each treatment within terminal nodes, stratified by low- versus high-dose methylprednisolone (MP). TPE- or Anakinra-based therapies were generally used in patients requiring respiratory support, whereas TPE was also used in those without respiratory support but with ferritin >1107 µg/L and MAS. Patients without respiratory support, ferritin ≤1107 µg/L, and CRP ≤ 12.65 mg/dL most often received IVIG + low-dose MP. Patients with CRP > 12.65 mg/dL without shock were typically managed with IVIG + low-dose MP plus Anakinra.
