Predictors of ICU Length of Stay in Patients with Severe Pneumonia: A Six-Year Retrospective Cohort Study Focusing on Traditional Chinese Medicine Adjuvant Therapy.

OBJECTIVE

To investigate the independent factors associated with the shortened Intensive Care Unit (ICU) stay in patients with severe pneumonia, and to provide a theoretical basis and practical reference for clinically optimizing the diagnosis and treatment strategies for severe pneumonia.

METHODS

A retrospective analysis was performed on the clinical data of patients with severe pneumonia treated at Meizhou People's Hospital in China from December 2019 to December 2025. With the ICU stay of patients as the dependent variable, potential influencing factors were screened in combination with clinical practice, including patients' baseline data, treatment methods (invasive mechanical ventilation, nutritional support, blood transfusion, adjuvant treatment with Heat-Clearing, Phlegm-Resolving and Fu-Unblocking Decoction), and comprehensive immune-inflammatory indicators before treatment. The correlation between these clinical indicators and characteristics of patients and the shortened ICU stay was analyzed.

RESULTS

The median length of ICU stay was 4 (2, 7) days. 602 (38.5%) patients with short ICU stay (<4 days) and 962 (61.5%) patients with long ICU stay (≥4 days). In patients with long ICU stay, the proportion of those with ARDS was significantly higher than that in patients with short ICU stay, whereas the proportion of those receiving therapeutic intervention with Heat-Clearing, Phlegm-Resolving and Fu-Unblocking Decoction was significantly lower (all p<0.001). In the adjusted model, absence of ARDS (odds ratio [OR]: 2.885, 95% confidence interval [CI]: 1.573-5.292, p=0.001), and receiving adjuvant therapy with the Heat-Clearing, Phlegm-Resolving and Fu-Unblocking Decoction (OR: 1.406, 95% CI: 1.018-1.940, p=0.038) were independently associated with a short ICU length of stay.

CONCLUSION

The absence of ARDS and adjuvant treatment with Heat-Clearing, Phlegm-Resolving and Fu-Unblocking Decoction may be associated with a short ICU stay in patients with severe pneumonia. However, the causal relationship needs to be confirmed by further studies.