Zheng Zhijuan, Yu Ming, Peng Guixia, Xiao Yue
Intensive Care Unit, Meizhou People's Hospital, Meizhou, People's Republic of China.
Department of Thyroid Surgery, Meizhou People's Hospital, Meizhou, People's Republic of China.
Int J Gen Med. 2025 Mar 29;18:1765-1776. doi: 10.2147/IJGM.S510659. eCollection 2025.
The length of intensive care unit (ICU) stay is an important index reflects the prognosis of severe pneumonia (SP) combined with respiratory failure (RF). Blood transfusion can alleviate tissue hypoxia in ICU patients, but blood transfusion can affect the prognosis of patients. The objective of this study was to evaluate the effect of immune-nutritional indices (pan-immune inflammation value (PIV), systemic immune inflammation index (SII), system inflammation response index (SIRI), neutrophil-to-albumin ratio (NAR), and prognostic nutritional index (PNI)) on length of stay in patients treated with and without transfusion.
Total of 3425 pneumonia combined with respiratory failure patients were retrospectively analyzed. Medical records (age, gender, body mass index, history of smoking, history of alcohol drinking, hypertension, diabetes mellitus, lung diseases, invasive mechanical ventilation, blood transfusion, APACHE II score, and laboratory test results) were collected, the relationship between this information and prolonged ICU stay was analyzed.
The average length of ICU stay was 5.32 (2.94, 9.36) days, there were 2521 (73.6%) patients with non-prolonged ICU stay (<9 days) and 904 (26.4%) with prolonged ICU stay (≥9 days). The levels of PIV, SII, and SIRI in prolonged ICU stay patients were higher than those of non-prolonged ICU stay in patients with and without blood transfusion, respectively. Multivariate logistic regression analysis showed that high SII (odds ratio (OR): 2.115, 95% confidence interval (CI): 1.428-3.131, <0.001), and invasive mechanical ventilation (OR: 10.205, 95% CI: 5.623-18.524, <0.001) were associated with prolonged ICU stay in patients with blood transfusion; and low PNI (OR: 1.378, 95% CI: 1.073-1.769, =0.012), invasive mechanical ventilation (OR: 3.566, 95% CI: 2.666-4.771, <0.001) were associated with prolonged ICU stay in patients without blood transfusion.
High SII level and invasive mechanical ventilation were independently associated with prolonged ICU stay in patients treated with blood transfusion; and low PNI level and invasive mechanical ventilation were independently associated with prolonged ICU stay in patients without blood transfusion.
重症监护病房（ICU）住院时间是反映重症肺炎（SP）合并呼吸衰竭（RF）预后的重要指标。输血可缓解ICU患者的组织缺氧，但输血会影响患者预后。本研究的目的是评估免疫营养指标（全免疫炎症值（PIV）、全身免疫炎症指数（SII）、系统炎症反应指数（SIRI）、中性粒细胞与白蛋白比值（NAR）和预后营养指数（PNI））对输血和未输血患者住院时间的影响。
回顾性分析3425例肺炎合并呼吸衰竭患者。收集病历（年龄、性别、体重指数、吸烟史、饮酒史、高血压、糖尿病、肺部疾病、有创机械通气、输血、APACHE II评分和实验室检查结果），分析这些信息与ICU住院时间延长之间的关系。
ICU平均住院时间为5.32（2.94，9.36）天，2521例（73.6%）患者ICU住院时间未延长（<9天），904例（26.4%）患者ICU住院时间延长（≥9天）。输血和未输血患者中，ICU住院时间延长患者的PIV、SII和SIRI水平分别高于住院时间未延长患者。多因素logistic回归分析显示，高SII（优势比（OR）：2.115，95%置信区间（CI）：1.428 - 3.131，<0.001）和有创机械通气（OR：10.205，95%CI：5.623 - 18.524，<0.001）与输血患者ICU住院时间延长相关；低PNI（OR：1.378，95%CI：1.073 - 1.769，=0.012）和有创机械通气（OR：3.566，95%CI：2.666 - 4.771，<0.001）与未输血患者ICU住院时间延长相关。
高SII水平和有创机械通气与输血患者ICU住院时间延长独立相关；低PNI水平和有创机械通气与未输血患者ICU住院时间延长独立相关。
