重症肺炎患者死亡的危险因素分析

Analysis of risk factors for mortality in patients with severe pneumonia

目的 探讨重症肺炎患者死亡的危险因素,为判断重症肺炎患者预后提供依据。方法 至2019年1月至2024年1月,回顾性收集中国人民解放军联勤保障部队第九〇一医院收治得重症肺炎患者200例,根据患者是否死亡,将患者分为死亡组(n=72)和存活组(n=128),比较两组患者主要临床特征,同时使用多因素logistics回归分析探讨重症肺炎患者死亡的危险因素。结果 两组患者入院氧合指数、降钙素原、意识障碍、胸腔积液、休克等方面存在统计学意义(P<0.05)。降钙素原对重症肺炎患者院内死亡具有一定预测价值,曲线下面积为0.661(95%可信区间:0.577~0.744,P=0.000)。氧合指数对重症肺炎患者存活均有一定预测价值,曲线下面积为0.722(95%可信区间:0.652~0.792,P=0.000)。意识障碍、休克、胸腔积液、氧和指数<235.5、降钙素原<4.44 ng/ml是重症肺炎患者院内死亡的独立危险因素(P<0.05)。结论 意识障碍、休克、胸腔积液、氧合指数降低和降钙素原增高是重症肺炎患者院内死亡的独立危险因素。

Objective To explore the risk factors for mortality in severe pneumonia patients and provide a basis for predicting the prognosis of severe pneumonia patients.Methods From January 2019 to January 2024,a retrospective study was conducted on 200 patients with severe pneumonia admitted to our hospital.According to whether the patients died, they were divided into a death group(n=72) and a survival group(n=128).The main clinical characteristics of the two groups of patients were compared, and multiple logistic regression analysis was used to explore the risk factors for death in severe pneumonia patients.Results There were statistically significant differences in terms of admission oxygenation index, procalcitonin, consciousness disorders, pleural effusion, and shock between the two groups of patients(P<0.05).Procalcitonin was valuable in predicting in-hospital mortality in severe pneumonia patients, with an area under the curve of 0.661(95% confidence interval: 0.577~0.744,P=0.000).The oxygenation index was valuable in predicting survival in severe pneumonia patients, with an area under the curve of 0.722(95% confidence interval: 0.652~0.792,P=0.000).Consciousness disorders, shock, pleural effusion, oxygenation index<235.5 and procalcitonin<4.44 ng/ml were independent risk factors for in-hospital mortality in severe pneumonia patients(P<0.05).Conclusion Consciousness disorders, shock, pleural effusion, decreased oxygenation index and increased procalcitonin levels are independent risk factors for in-hospital mortality in severe pneumonia patients.