Analysis Of Risk Factors For Death Of Severe Pneumonia With Acute Respiratory Failure In PICU

Objective:Through the analysis of the clinical data of children with severe pneumonia complicated with acute respiratory failure in PICU Affiliated Children's Hospital of Nanchang University,to explore the risk factors for death of severe pneumonia with respiratory failure in PICU.Method:This paper retrospectively analyzes the clinical data of 221 children with severe pneumonia complicated with ARF(Acute Respiratory Failure)in the PICU of Affiliated Children's Hospital of Nanchang University from September 1,2017 to September 1,2019.It is scheduled to divide these children into the death group and the survival group which includes the ones who have been cured or become better,and carry out univariate and multivariate analyses of various factors including general conditions,laboratory tests(blood routine,liver function,myocardial enzyme spectrum,CRP,PCT,etiological results,etc.),basic diseases,PCIS and treatment.P<0.05 means the difference is statistically significant.Results:1.Among the 221 cases,143 were male(67.87%),78 were female(32.13%),and the male to female ratio was 1.83: 1.The proportion of women in the death group(57.78%)was higher than that in the survival group(29.55%),the difference was statistically significant(c2=12.51,P=0.00).2.Among the 221 cases,the median age(M)is 118 days old,the main 158 cases(71.49%)are infants(<1 year old),and the proportion of infants in the death group(88.89%)is higher than that in the survival group(67.05%),showing a statistical difference(P<0.05)?3.Among the 221 patients,the average length of hospitalization is 17.35±11.96,and the average length of hospitalization in the death group is shorter than that in thesurvival group(12.91±13.3 vs 18.49±11.36,P=0.00).4.There are seven cases of cyanosis in the death group(15.56%)more cases than the survival group 3.The difference is statistically significant(1.70%)(P=0.00).5.Among the 221 cases,125 people(56.56%)have basic diseases.The proportion of the death group with basic diseases(75.56%)is higher than that of the survival group,and the difference is statistically significant(51.70%)(P=0.004).Among them,the proportion of preterm delivery(35.56%)and low birth weight(44.22%)in the death group are both higher than that of the survival group(21.59%,25.57%,P<0.05).6.Among 221 children,82(37.10%)have mixed infection.The proportion of mixed infection in the death group is higher than that in the survival group(55.55%vs32.29%,P=0.004).The difference is statistically significant,and the proportion of syncytial virus mixed with adenovirus infection in the death group is higher than that of the survival group(24.00%vs10.53%,P=0.034).7.All the 221 children have been given PCIS,of which the proportion of the survival group with the scores from 81 to 100(56.25%)is significantly higher than that of the death group(13.33%)(P=0.00).The proportion of the death group with the scores less than 70(62.22%)is higher than that of the survival group(22.16%)(P=0.00).Pairwise comparison of scores in the three groups shows statistical differences(P<0.05).8.Univariate analysis showed that there were significant differences in age,female,cyanosis,basic diseases,premature delivery,low birth weight,anemia,mixed infection,PLT,Hb,ALB,PCT and CRP between the two groups(P < 0.05).9.Multivariate analysis showed that anemia,preterm delivery,PCIs score,PLT,CRP,mixed infection and c-ball treatment were significantly different between the two groups(P < 0.05).Conclusion:1.Infants are high-risk population of death in severe pneumonia complicatedwith ARF.2.Premature birth,low birth weight underlying disease in Severe pneumonia with ARF can increase the risk of death.3.Mixed infection(especially syncytial virus and adenovirus)in severe pneumonia with acute respiratory failure may increase the risk of death.4.Anemia,preterm delivery,low PCIs score,low PLT,high CRP,mixed infection are Independent risk factors for death in severe pneumonia with acute respiratory failure.5.Some children with severe pneumonia and ARF can benefit from the treatment of globulin.