Predictive Value of Inflammatory and Immune Markers for Acute Respiratory Failure in Patients With Community-Acquired Pneumonia.

AIMS/

BACKGROUND

Acute respiratory failure (ARF) may develop in some patients with community-acquired pneumonia (CAP), resulting in a significantly increased mortality rate. Early identification of high-risk patients is essential for improving prognosis. This study aimed to investigate the predictive value of inflammatory and immune markers for acute respiratory failure in patients with community-acquired pneumonia.

METHODS

This single-center retrospective cohort study included 334 patients with community-acquired pneumonia admitted at Zhuji Sixth People's Hospital, between January 2021 and December 2024. Patients were divided into a CAP-only (non-event) group and a CAP-ARF (event) group based on the development of acute respiratory failure. Inflammatory markers (white blood cell count, neutrophil count, tumor necrosis factor-α, etc.) and immune markers (complement components 3 and 4[C3andC4], immunoglobulins A and G [IgAand IgG], etc.) were collected within 24 hours of admission. Univariate and multivariate logistic regression analyses were performed to identify independent predictive factors, and the predictive performance of individual and combined indicators was evaluated using receiver operating characteristic (ROC) curves.

RESULTS

Multivariate analysis showed that elevated white blood cell count, neutrophil count, and tumor necrosis factor-α levels were independent risk factors for acute respiratory failure, while decreased levels of complement C3 and C4, and IgA and IgG, were independent protective factors. The combined predictive model incorporating these indicators demonstrated excellent predictive performance for acute respiratory failure, with an area under the curve (AUC) of 0.853.

CONCLUSION

In patients with community-acquired pneumonia, inflammatory and immune markers exhibit significant predictive value for the development of acute respiratory failure. A combined assessment of white blood cell count, neutrophil count, tumor necrosis factor-α, complement C3 and C4, and IgA and IgG may facilitate early identification of high-risk patients and inform clinical decision-making.