Enhancing Prognostic Assessment for Influenza-Associated Pneumonia: An Examination of Contributing Risk Factors.

ABSTRACT

Objective: This study aims to analyze the prognostic risk factors influencing patient outcomes in cases of influenza-associated pneumonia. Methods: We comprehensively analysed clinical data from patients admitted to the First Affiliated Hospital of Wenzhou Medical University between December 2017 and April 2019. Patients with confirmed influenza-associated pneumonia, determined through nucleic acid detection in throat swabs or sputum samples, were included in the study. The collected data were meticulously analyzed to identify significant prognostic risk factors. Results: A total of 151 patients diagnosed with influenza-associated pneumonia were included in the final analysis, yielding a fatality rate of 19.87% (30/151). The application of multivariate regression analysis revealed that several independent risk factors significantly affected the prognosis of patients afflicted with influenza-associated pneumonia. These included lymphocyte count (L), oxygenation index (O), albumin (A), and urinary (U) levels. Receiver operating characteristic (ROC) curve analysis further elucidated the prognostic value of these factors. Specifically, the Composite Index LOAU (Lymphocyte, Oxygenation index, Albumin, Urinary) demonstrated a robust area under the curve (AUC) of 0.909 (95% CI 0.851-0.950), surpassing the performance of established scoring systems, such as the pneumonia severity index (PSI) (AUC = 0.746), Apache II (AUC = 0.732), and CURB-65 (AUC = 0.662). These differences were statistically significant (P < .05). Conclusions: The prognosis of influenza-associated pneumonia can be effectively predicted by assessing peripheral blood parameters, including lymphocyte count, albumin level, urinary markers, and the oxygenation index upon admission. Notably, the Composite Index LOAU, as a comprehensive amalgamation of these factors, holds promising potential to enhance prognostic precision and management outcomes in cases of influenza-associated pneumonia.