Analysis on Clinical Characteristics and Outcomes of Severe Community-Acquired Pneumonia(SCAP)in Lhasa

Wan Haiye; Meilang Qucuo

doi:10.3969/j.issn.1004-3403.2025.05.011

Abstract：Objective Patients with severe community-acquired pneumonia(SCAP)usually have a poor prognosis,and the aim of this study is to compare the clinical characteristics and hospitalization outcomes between patients with severe community-acquired pneumonia and those with non-severe community-acquired pneumonia(NSCAP)in Lha-sa to explore the risk factors for mortality.Methods A total of 202 pneumonia patients aged ≥ 18 years admitted to the Department of Respiratory and Critical Care Medicine at People's Hospital of Xizang Autonomous Region from March,2023 to March,2024 were selected for retrospective analysis,and were divided into the SCAP group(n=62)and the NSCAP group(n=140)according to whether they met the diagnostic criteria for severe pneumonia,and the clinical characteristics and outcomes of the patients in the two groups were compared.Results Among the 62 SCAP patients,61.29％were male,aged(66.16±14.78)years,with a median hospital stay of 13.50 days,with common clin-ical symptoms of cough,sputum,dyspnoea and impaired consciousness,and with common comorbidities of cardio-vascular diseases,choronic obstructive pulmonary diseases(COPD),diabetes mellitus,chronic kidney disease(CKD),pulmonary embolism and other underlying diseases.It was found that the total count of white blood cells(WBC),neutrophils,C-reactive proteins(CRP)and procalcitonins were higher in the SCAP group than in the NSCAP group,while that of lymphocytes was lower.The most common pathogens in patients in the SCAP group were Candi-da albicans(14.03％),influenza A virus(10.53％),Acinetobacter baumannii(5.26％)and Escherichia coli(5.26％),while those in the NSCAP group were coronavirus(9.09％),Candida albicans(7.58％)and influenza A virus(6.06％).Univariate analysis showed that hospitalisation stay,comorbid CKD,impaired consciousness,total count of WBC,neutrophil,lymphocyte protocalcitonin and CRP were significantly associated with mortality in SCAP patients.Among which,hospitalization stay,impaired consciousness and CRP were independent risk factors for mortality in SCAP patients.Conclusion SCAP is predominantly seen in elderly males,with common clinical symptoms such as cough,sputum,fever,dyspnoea and impaired consciousness,and are often accompanied by underlying diseases such as cardiovascular diseases,COPD,diabetes mellitus CKD,as well as higher lever of WBC and neutrophil count,pro-tocalcitonin and CRP and lower lymphocyte count.