Incidence and risk factor of sepsis in patients with severe community-acquired pneumonia: a Chinese, single-center, retrospective study
Abstract Background Sepsis represents a high-risk mortality cohort among patients with severe community-acquired pneumonia (SCAP). Rapid and precise identification along with prompt decision-making, serves as a practical approach to improve patient prognosis. Methods This retrospective observational...
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2025-05-01
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| Online Access: | https://doi.org/10.1186/s12879-025-11027-w |
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| author | Xinyu Wang Chang Wei Dingxiu He Dong Huang Yuean Zhao Longyi Ran Xinyuan Wang He Yu Zongan Liang Linjing Gong |
| author_facet | Xinyu Wang Chang Wei Dingxiu He Dong Huang Yuean Zhao Longyi Ran Xinyuan Wang He Yu Zongan Liang Linjing Gong |
| author_sort | Xinyu Wang |
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| description | Abstract Background Sepsis represents a high-risk mortality cohort among patients with severe community-acquired pneumonia (SCAP). Rapid and precise identification along with prompt decision-making, serves as a practical approach to improve patient prognosis. Methods This retrospective observational study enrolled adult patients with severe community-acquired pneumonia (SCAP) who were continuously hospitalized in the intensive care unit (ICU) of West China Hospital, Sichuan University, from September 2011 to September 2019. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors for co-sepsis, followed by the utilization of LASSO regression to filter features to establish a nomogram. Model robustness was evaluated via the C index, receiver operating characteristic (ROC) analysis, and calculation of the area under the curve (AUC). Furthermore, its predictive accuracy was assessed via decision curve analysis (DCA). Results In total, 5855 SCAP patients were included in the present study, of whom 654 developed sepsis. Patients with sepsis exhibited a prolonged length of stay in the ICU and higher mortality rates, indicating a worse prognosis than those without sepsis. We identified 15 independent risk factors associated with the development of sepsis in SCAP patients. Further analysis incorporating 9 of these features to construct a nomogram demonstrated a C index of 0.722 (95%CI 0.702–0.742), including lactate, D-dimer, respiratory rate, heart rate, albumin, hemoglobin, activated partial thromboplastin time (APTT), glucose, and C-reactive protein (CRP) levels. The AUC values and DCA curves demonstrated that the model exhibited superior accuracy and overall net benefit in predicting co-sepsis development compared with the qSOFA, CURB-65, SOFA, and APACHE II scores. Additionally, the calibration curve confirmed good concordance between the predicted probabilities of the model. Conclusions This study investigated the risk factors for co-sepsis in SCAP patients and constructed an expedited, cost-effective and personalized model for predicting the probability of co-sepsis. |
| format | Article |
| id | doaj-art-7d8df3a3ecfd42fda3de7ede436a6711 |
| institution | DOAJ |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj-art-7d8df3a3ecfd42fda3de7ede436a67112025-08-20T02:55:28ZengBMCBMC Infectious Diseases1471-23342025-05-0125111310.1186/s12879-025-11027-wIncidence and risk factor of sepsis in patients with severe community-acquired pneumonia: a Chinese, single-center, retrospective studyXinyu Wang0Chang Wei1Dingxiu He2Dong Huang3Yuean Zhao4Longyi Ran5Xinyuan Wang6He Yu7Zongan Liang8Linjing Gong9Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan UniversityDepartment of Respiratory and Critical Care Medicine, West China Hospital, Sichuan UniversityDepartment of Emergency Medicine, The People’s Hospital of DeyangDepartment of Respiratory and Critical Care Medicine, West China Hospital, Sichuan UniversityDepartment of Respiratory and Critical Care Medicine, West China Hospital, Sichuan UniversityDepartment of Respiratory and Critical Care Medicine, West China Hospital, Sichuan UniversityDepartment of Orthopaedics, West China Hospital, Sichuan UniversityDepartment of Respiratory and Critical Care Medicine, West China Hospital, Sichuan UniversityDepartment of Respiratory and Critical Care Medicine, West China Hospital, Sichuan UniversityDepartment of Respiratory and Critical Care Medicine, West China Hospital, Sichuan UniversityAbstract Background Sepsis represents a high-risk mortality cohort among patients with severe community-acquired pneumonia (SCAP). Rapid and precise identification along with prompt decision-making, serves as a practical approach to improve patient prognosis. Methods This retrospective observational study enrolled adult patients with severe community-acquired pneumonia (SCAP) who were continuously hospitalized in the intensive care unit (ICU) of West China Hospital, Sichuan University, from September 2011 to September 2019. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors for co-sepsis, followed by the utilization of LASSO regression to filter features to establish a nomogram. Model robustness was evaluated via the C index, receiver operating characteristic (ROC) analysis, and calculation of the area under the curve (AUC). Furthermore, its predictive accuracy was assessed via decision curve analysis (DCA). Results In total, 5855 SCAP patients were included in the present study, of whom 654 developed sepsis. Patients with sepsis exhibited a prolonged length of stay in the ICU and higher mortality rates, indicating a worse prognosis than those without sepsis. We identified 15 independent risk factors associated with the development of sepsis in SCAP patients. Further analysis incorporating 9 of these features to construct a nomogram demonstrated a C index of 0.722 (95%CI 0.702–0.742), including lactate, D-dimer, respiratory rate, heart rate, albumin, hemoglobin, activated partial thromboplastin time (APTT), glucose, and C-reactive protein (CRP) levels. The AUC values and DCA curves demonstrated that the model exhibited superior accuracy and overall net benefit in predicting co-sepsis development compared with the qSOFA, CURB-65, SOFA, and APACHE II scores. Additionally, the calibration curve confirmed good concordance between the predicted probabilities of the model. Conclusions This study investigated the risk factors for co-sepsis in SCAP patients and constructed an expedited, cost-effective and personalized model for predicting the probability of co-sepsis.https://doi.org/10.1186/s12879-025-11027-wSevere community-acquired pneumoniaSepsisClinical characteristicsRisk factorsNomogramMortality |
| spellingShingle | Xinyu Wang Chang Wei Dingxiu He Dong Huang Yuean Zhao Longyi Ran Xinyuan Wang He Yu Zongan Liang Linjing Gong Incidence and risk factor of sepsis in patients with severe community-acquired pneumonia: a Chinese, single-center, retrospective study BMC Infectious Diseases Severe community-acquired pneumonia Sepsis Clinical characteristics Risk factors Nomogram Mortality |
| title | Incidence and risk factor of sepsis in patients with severe community-acquired pneumonia: a Chinese, single-center, retrospective study |
| title_full | Incidence and risk factor of sepsis in patients with severe community-acquired pneumonia: a Chinese, single-center, retrospective study |
| title_fullStr | Incidence and risk factor of sepsis in patients with severe community-acquired pneumonia: a Chinese, single-center, retrospective study |
| title_full_unstemmed | Incidence and risk factor of sepsis in patients with severe community-acquired pneumonia: a Chinese, single-center, retrospective study |
| title_short | Incidence and risk factor of sepsis in patients with severe community-acquired pneumonia: a Chinese, single-center, retrospective study |
| title_sort | incidence and risk factor of sepsis in patients with severe community acquired pneumonia a chinese single center retrospective study |
| topic | Severe community-acquired pneumonia Sepsis Clinical characteristics Risk factors Nomogram Mortality |
| url | https://doi.org/10.1186/s12879-025-11027-w |
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