•  
  •  
 

Abstract

bjective: Severe pneumonia (SP) accompanied by high fever is frequently encountered in pediatric emergency and intensive care settings and is associated with unfavorable short-term outcomes. Early identification of factors associated with poor prognosis may support timely risk recognition and nursing awareness. Methods: This retrospective observational study included 195 children with SP complicated by high fever who were admitted to the Pediatric Intensive Care Unit (PICU) or the Emergency Department of our hospital between January 2019 and January 2022. Demographic characteristics, baseline clinical indicators, and laboratory parameters at admission were extracted from medical records. Poor prognosis was determined according to predefined short-term outcome criteria during hospitalization and follow-up. Univariable and multivariable logistic regression analyses were performed to identify factors associated with poor prognosis. An exploratory nomogram based on the multivariable model was constructed. Results: Among the 195 children, 33 experienced poor prognoses. Univariable analyses showed that younger age, longer fever duration, higher respiratory rate, lower peripheral oxygen saturation (SpO₂), higher C-reactive protein (CRP), lower lymphocyte counts, and lower platelet count were associated with poor prognosis. In multivariable analysis, higher respiratory rate (OR = 1.240, 95% CI 1.041-1.478, P = 0.015) and elevated CRP (OR = 1.429, 95% CI 1.257-1.623, P < 0.001) remained independently associated with poor prognosis, while age showed a non-significant trend. An exploratory nomogram incorporating age, respiratory rate, and CRP was developed for illustrative purposes. Conclusion: In children with SP complicated by high fever, higher respiratory rate and elevated CRP at admission were independently associated with poor prognosis. These findings may support early risk recognition and inform clinical monitoring and nursing awareness. The exploratory nomogram provides a visual summary of associated factors and is not a validated prediction tool; prospective studies are warranted to evaluate risk-guided nursing strategies.

Download

Share

COinS