Multiple Organ Dysfunction Syndrome Associated With Pneumonia: A Retrospective Study With a Focus on Respiratory Failure

<b>Aims/Background</b> Pneumonia is a complex condition with rapid progression, often leading to multiple organ dysfunction syndrome (MODS), which significantly impacts patient quality of life and prognosis. This study aims to identify risk factors closely associated with the development of MODS by conducting a retrospective analysis of clinical data from 150 patients with pneumonia, providing insights for informing the prevention and treatment of pneumonia. <b>Methods</b> We recruited 150 patients with pneumonia admitted to Huzhou Third Municipal Hospital, the Affiliated Hospital of Huzhou University between 2019 and 2022. The patients were divided into two groups according to whether they had developed MODS: the non-MODS group (<i>n</i> = 100) and the MODS group (<i>n</i> = 50). Patients' data, such as their demographic information, clinical characteristics, laboratory test results, treatment course and outcomes, were collected. Logistic regression analysis was conducted to determine the independent predictors of MODS occurrence. <b>Results</b> After propensity score matching, the baseline data of the two groups of patients presented no significant difference (<i>p</i> > 0.05). The predominant clinical and laboratory manifestations of both groups of patients were fever, cough, decreased arterial partial pressure of oxygen (PaO₂), as well as elevated white blood cell (WBC) count, C-reactive protein (CRP) level, and procalcitonin (PCT) level, but inter-group differences in these metrics were not statistically significant (<i>p</i> > 0.05). However, the clinical manifestation of dyspnea was significantly more prevalent in the MODS group (<i>p</i> < 0.01). The MODS group also had a significantly higher likelihood of receiving mechanical ventilation and renal replacement therapy (<i>p</i> < 0.001), as well as experiencing respiratory failure, cardiac failure, and death (<i>p</i> < 0.01). Univariate analysis indicated that factors including age ≥65 years, WBC count ≥15 × 10⁹/L, PCT ≥2 ng/mL, PaO₂ ≤60 mmHg, arterial partial pressure of carbon dioxide (PaCO₂) ≥50 mmHg, severe pneumonia, and dyspnea were associated with a significantly increased risk of MODS (<i>p</i> < 0.05). These factors, except for the PCT, were validated as independent risk factors for MODS in the multivariate logistic regression analysis (<i>p</i> < 0.05). <b>Conclusion</b> Age ≥65 years, WBC count ≥15 × 10⁹/L, PaO₂ ≤60 mmHg, PaCO₂ ≥50 mmHg, severe pneumonia, and dyspnea are independent risk factors for developing MODS in patients with pneumonia. Patients with MODS presenting respiratory failure as the main manifestation have a high mortality rate, and timely mechanical ventilation and supportive treatment are essential to improve the prognosis.