The mortality risk factor of severe community-acquired pneumonia (SCAP) patients with Sepsis: a retrospective study

<p><strong><span>Objectives:</span></strong><span> Sepsis is one of the most common comorbidities in severe community-acquired pneumonia (SCAP) patients. We aimed to investigate the characteristics and mortality risk factors of SCAP patients hospitalized with Sepsis.</span></p> <p><strong><span>Design:</span></strong><span> A retrospective, single-centre study.</span></p> <p><strong><span>Setting:</span></strong><span> This study was conducted at a tertiary hospital in Southern China.</span></p> <p><strong><span>Participants:</span></strong><span> A total of 119 patients with SCAP, aged 17 years or older, were treated in the Integrated intensive care unit from 1 January 2018 to 30 December 2020.</span></p> <p><strong><span>Interventions:</span></strong><span> none.</span></p> <p><strong><span>Outcome:</span></strong><span> 180-day mortality was the primary outcome.</span></p> <p><span><strong>Results:</strong></span><span> 119 patients were divided into the survivors (83 patients,69.75%), and the non-survivors (36 patients,30.25%). There are more pronounced inflammatory responses and respiratory problems at the beginning of the disease in non-survivors, requiring stronger respiratory and circulatory support.</span> <span>The CURB-65 score was a better predictor of mortality than the PSI and APACHE2 scores, AUCs of CURB-65: OR 0.744, p&lt;0.005.</span> <span>For the entire treatment cycle, the non-survivors had a longer duration of persistent fever, required continuous and repeated airway intervention, and a longer duration of Vasopressor support (P&lt;0.001). SCAP with bacterial infection as the onset, </span><span>or secondary bacterial infection had a poor prognosis (P=0.018). The non-survivors had more use of different types of antimicrobials (P&lt;0.05), because of Multidrug-resistant (MDR) organisms. And have faced more antifungal treatment failures (P=0.006). The</span> <span>mortality risk factors were comorbid with a duration of Vasopressors support, duration of persistent fever, age, numbers of antimicrobials for MDR organisms, CURB-65 score and duration of Neuromuscular Blocking Agents (NMBAs) (OR=1.234, OR=1.158, OR=1.084, OR=6.484, OR=3.386, OR=1.505, p&lt;0.005, respectively).</span></p> <p><strong><span>Conclusion:</span></strong><span> Dynamic monitoring of the duration of patients' abnormal indicators can help predict the prognosis. Age≥65.5 years, fever duration ≥9.5 days, number of antimicrobials</span> <span>for MDR organisms ≥2 types</span><span>, longer NMBAs and Vasopressors use, and higher CURB-65 score were mortality risk factors in SCAP-Sepsis patients.</span></p>