Analysis of Clinical Features and Prognostic Factors of Patients with Severe Community-Acquired Pneumonia Complicated with Septic Shock
Objective To analyze the clinical features and prognostic factors of patients with severe community-ac-quired pneumonia(SCAP)complicated with septic shock(SS).Methods From January 2023 to June 2024,174 patients with SCAP and SS admitted to intensive care unit(ICU),Anting hospital,Jiading district,Shanghai were gathered.Based on the 28-day prognosis of these patients,they were separated into a survival group(142 cases)and a death group(32 cases).Logistic regression analysis was used to screen the factors affecting the prognosis of SCAP complicated with SS patients.Re-sults There was no statistically significant difference between the survival group and the death group in terms of gender,body temperature,respiratory rate,heart rate,mean arterial pressure,hemoglobin,and D-dimer(P＞0.05),however,there were statistically great differences in age,body mass index,white blood cell count,platelet count,serum creatinine,C-reactive protein,N-terminal pro-brain natriuretic peptide,procalcitonin,prothrombin time,fibrinogen,pH,oxygenation index,blood lactate,Glasgow score,24-hour fluid replacement volume,norepinephrine dosage,acute physiology and chronic health evalu-ationⅡscore,confusion,uremia,respiratory,BP,age 65 years score,sepsis related organ failure assessment score,duration of use of vascular active drugs,mechanical ventilation,and ICU stay(P＜0.05).Logistic regression analysis showed that serum creatinine(OR=2.693,P＜0.01),C-reactive protein(OR=5.056,P=0.001),procalcitonin(OR=6.113,P＜0.01),blood lactate(OR=6.678,P=0.001),and 24-hour fluid replacement volume(OR=5.735,P=0.005)were independent risk factors for 28-day mortality in SCAP patients with SS.Conclusion Blood creatinine,C-reactive protein,procalcitonin,blood lactate,and 24-hour fluid replacement volume are independent risk factors for 28-day mortality in SCAP patients with SS.
Severe community-acquired pneumoniaSeptic shockClinical featuresPrognosisInfluence factor
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