Prognostic Factors Of Severe Community-Acquired Pneumonia

Objective:The purpose of this study was to improve clinicians’ understanding of the factors associated with short-term adverse outcomes in patients with severe community-acquired pneumonia(SCAP)by analyzing the factors associated with death within 30 days of hospitalization,to improve the prognosis of patients with SCAP,it is necessary to manage the patients with pneumonia and to intervene the risk factors.Methods: From January 2021 to the end of December 2022,medical record numbers of discharged patients mainly diagnosed as "community-acquired pneumonia,severe pneumonia" and "severe pneumonia" were collected from the medical record department of Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine.Clinical data of the patients were retrospectively collected,and a total of 737 cases were collected.After strict inclusion and exclusion criteria screening,a total of 199 patients were included,and were divided into survival group(119 cases)and death group(80 cases)according to whether SCAP patients survived within 30 days of hospitalization.Basic data,laboratory examination,imaging examination,scoring system,TCM syndrome differentiation,etc.,were collected,a database was established,statistical analysis was conducted using SPSS25.0 statistical software,and multiple Logistic regression analysis was performed to explore the risk factors and protective factors of death within 30 years of hospitalization of patients with SCAP.Results:1.Comparison between the two groups: There were statistically significant differences between the two groups in terms of invasive mechanical ventilation,septic shock,disorder of consciousness,combination of extrapulmonary tumors,heart rate,systolic blood pressure,arterial blood gas p H,FIB,ALB,K+,RDW,CRP,NT-pro BNP,IL-6,LAC,D-dimer,GLU and BUN(P<0.05);2.Logistic regression analysis showed that disturbance of consciousness,high LAC,high GLU and high RDW were the risk factors of short-term death,while Alb and CRP were the protective factors,the patients with higher ALB and CRP had lower risk of death.Conclusions: The 30-day mortality of SCAP in our hospital was about 40%,The main pathogens were influenza virus B and Klebsiella pneumoniae,disturbance of consciousness.The prognosis of critically ill patients is poor,while the prognosis of excess evil energy patients is often better.High LAC,High GLU and High RDW were the risk factors of short-term death in SCAP patients,while high ALB was the protective factor.