Dynamic changes and time-dependent analysis of mortality risk factors in severe pneumonia patients
10.3760/cma.j.cn114656-20250303-00154
- VernacularTitle:重症肺炎患者死亡危险因素的动态变化及时间依赖性分析
- Author:
Wenkao ZHOU
1
;
Lide SU
;
Lingyan HUANG
;
Ailin GUO
;
Yimei PAN
;
Zonghong LIU
;
Yaben YAO
Author Information
1. 厦门大学附属翔安医院急诊医学科（医务室），厦门 361100
- Keywords:
Severe Pneumonia;
Mortality Risk Factors;
Survival Status
- From:
Chinese Journal of Emergency Medicine
2025;34(8):1071-1077
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze mortality risk factors in patients with severe pneumonia and investigate their varying influences across different time periods.Methods:A total of 134 patients with severe pneumonia admitted to the Emergency Department of Xiang’an Hospital, Xiamen University, between June 2019 and February 2020 were enrolled. All patients were treated in the EICU and followed up for four years. Based on outcomes, they were categorized into a death group ( n=77) and a survival group ( n=57). COX regression analysis was employed to identify mortality risk factors at different time points, while logistic regression analysis was used to assess risk factors influencing mortality during hospitalization, ICU stay, 1-month, and 1-year follow-up periods. Results:Mortality rates were 11.9% ( n=16) during ICU admission, 20.8% ( n=28) during hospitalization, 16.4% ( n=22) within 1 month, and 31.3% ( n=42) within 1 year. By the end of the follow-up, 57.4% ( n=77) of patients had died. Ten mortality risk factors were identified, with the number increasing over time. During ICU admission and hospitalization, significant risk factors included total bilirubin levels, APACHE-II score, invasive ventilation, ARDS, and vasopressor use in the ICU. One-month mortality risk additionally involved bacterial infection. One-year mortality risk further incorporated advanced age and chronic heart failure. By the end of follow-up, acute kidney injury (AKI) during ICU admission also emerged as a contributing factor, while higher body weight was identified as a protective factor. Conclusions:The number of mortality risk factors in severe pneumonia patients increases progressively over time. Early-stage factors during hospitalization and ICU admission exert a stronger impact on short-term mortality, whereas bacterial infection, advanced age, and chronic heart failure become increasingly significant in later stages. These findings highlight the dynamic nature of risk factors and underscore the importance of tailored monitoring and intervention strategies at different disease phases.
