重症监护室重症社区获得性肺炎患者的临床特征和与死亡率相关的危险因素
Clinical characteristics and risk factors associated with mortality in patients with severe community-acquired pneumonia in the intensive care unit.
摘要(中文译文)
重症监护病房（ICU）中重症社区获得性肺炎（CAP）患者的病死率较高。早期识别重症CAP并及时转入适当的医疗单元似乎是有益的。本研究旨在明确ICU中重症CAP（ICU-CAP）的临床特征及与病死率相关的危险因素。本研究为多中心前瞻性研究，于2017年12月至2021年10月在中国11家教学医院开展。符合纳入标准的患者根据是否入住ICU分为ICU组和非ICU组。共纳入170例重症CAP患者，其中111例入住ICU，59例入住普通病房。ICU患者中，91.9%存在呼吸衰竭，65.8%存在意识障碍，23.4%处于休克状态，73.0%（81/111）的患者至少合并一种基础疾病。ICU-CAP的院内病死率为34.2%（38/111），28天病死率为27.9%（31/111），7天病死率为10.8%（12/111）。肺炎严重指数V级（PSI-V）患者的病死率为40.0%（18/45），接受有创机械通气患者的病死率为40.2%（33/82）。在ICU亚组中，有创机械通气[比值比（OR）=3.35；95%置信区间（CI）：1.14-9.81；P=0.02]和年龄≥60岁（OR=2.64；95%CI：1.07-6.53；P=0.03）与院内病死率独立相关。在这一多中心前瞻性队列中，入住ICU的重症CAP患者病情严重程度高，治疗失败率和病死率均较高。有创机械通气和年龄≥60岁与ICU亚组的院内病死率相关。
Abstract
The mortality rate among patients in the intensive care units (ICUs) with severe community-acquired pneumonia (CAP) is high. Identification of severe CAP early in the course and transferring to appropriate setting seem favorable. This study aimed to identify clinical characteristics and the risk factors associated with mortality of severe CAP in the ICU (ICU-CAP). A multi-center, prospective study was conducted at 11 teaching hospitals in China from December 2017 to October 2021. Patients who met the inclusion criteria were assigned to the ICU group and the non-ICU group according to whether they were admitted to the ICU. A total of 170 patients with severe CAP were included, 111 patients were admitted to the ICU and 59 patients were admitted to the ward. Among patients in the ICU, 91.9% of patients were with respiratory failure, 65.8% of patients with consciousness disturbance, 23.4% were in shock state, and 73.0% (81/111) of patients had at least one comorbidity. In-hospital mortality for ICU-CAP was 34.2% (38/111), 28-day mortality was 27.9% (31/111), and 7-day mortality was 10.8% (12/111). Mortality in patients with pneumonia severity index class V (PSI-V) was 40.0% (18/45), mortality in patients with invasive mechanical ventilation was 40.2% (33/82). In the ICU subgroup, invasive mechanical ventilation [odds ratio (OR) =3.35; 95% confidence interval (CI): 1.14-9.81; P=0.02] and age ≥60 years (OR =2.64; 95% CI: 1.07-6.53; P=0.03) were independently associated with in-hospital mortality. In this multicenter prospective cohort, severe CAP patients admitted to the ICU exhibited substantial disease severity, with high rates of treatment failure and mortality. Invasive mechanical ventilation and age ≥60 years were associated with in-hospital mortality in the ICU subgroup.
如何引用
AMA
Kang Zhang, Wenshuai Ji, Hao Yang, Xinyu Miao, Xiaoxuan He, Kai Xie, et al. Clinical characteristics and risk factors associated with mortality in patients with severe community-acquired pneumonia in the intensive care unit.. Journal of thoracic disease. 2026; doi:10.21037/jtd-2026-0531.
APA
Kang Zhang, Wenshuai Ji, Hao Yang, Xinyu Miao, Xiaoxuan He, Kai Xie, et al (2026). Clinical characteristics and risk factors associated with mortality in patients with severe community-acquired pneumonia in the intensive care unit.. Journal of thoracic disease. https://doi.org/10.21037/jtd-2026-0531
GB/T 7714
Kang Zhang, Wenshuai Ji, Hao Yang, Xinyu Miao, Xiaoxuan He, Kai Xie, et al. Clinical characteristics and risk factors associated with mortality in patients with severe community-acquired pneumonia in the intensive care unit.[J]. Journal of thoracic disease, 2026 doi:10.21037/jtd-2026-0531.
在 PubMed增强版 阅读全文
翻译全文 · AI 文献问答 · PDF 原文下载 · 引用导出