Association of Systemic Inflammatory Markers with 28-Day Mortality in Patients with Severe Pneumonia: A Retrospective Study from a Single Center - Report - MDSpire

Association of Systemic Inflammatory Markers with 28-Day Mortality in Patients with Severe Pneumonia: A Retrospective Study from a Single Center

  • By

  • Xingxing Chen

  • Weiqiang Huang

  • Wenjing Dai

  • Wei Zhang

  • Xiaofeng Zhong

  • Ming Hu

  • April 21, 2026

  • 0 min

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Association of Systemic Inflammatory Markers with 28-Day Mortality in Patients with Severe Pneumonia

Overview

This study evaluates the association of systemic inflammatory indices with 28-day mortality in ICU patients with severe pneumonia. The systemic immune-inflammation index (SIRI) and neutrophil-to-lymphocyte ratio (NLR) were identified as significant independent predictors of mortality.

Background

Severe pneumonia is a leading cause of ICU admissions and mortality, particularly among vulnerable populations. Current severity assessment tools may not adequately reflect the inflammatory response, which is crucial for risk stratification. Identifying reliable inflammatory markers can enhance early prognostic capabilities in clinical settings.

Data Highlights

IndexOR (95% CI)
SIRI2.16 (1.08–4.33)
NLR2.12 (1.14–3.95)

Key Findings

  • SIRI and NLR were significantly associated with 28-day mortality in severe pneumonia patients.
  • Each 1-standard deviation increase in SIRI and NLR correlated with higher odds of mortality.
  • PLR and SII were not independently associated with 28-day mortality after adjustment.
  • The study included 100 ICU patients, with 37 in the death group and 63 in the non-death group.
  • Findings suggest that inflammation-based indices may provide prognostic information beyond conventional severity markers.

Clinical Implications

Clinicians should consider incorporating SIRI and NLR into their assessment protocols for patients with severe pneumonia to improve risk stratification. These indices may help identify patients at higher risk of mortality, guiding more aggressive management strategies.

Conclusion

SIRI and NLR are promising inflammatory markers that can enhance the prediction of 28-day mortality in severe pneumonia. Further validation in larger cohorts is necessary to confirm these findings.

References

  1. Critical Care (Springer), 2026 -- Baseline serum matrix metalloproteinase-8 and 28-day mortality in sepsis at ICU admission
  2. Infection, 2024 -- The Relationship Between Serum Osmolality and 28-Day Mortality Rates in Sepsis Patients: Findings from a Retrospective Cohort Analysis
  3. Intensive Care Medicine, 2023 -- Evaluating Procalcitonin and C-reactive Protein Levels to Exclude Early Bacterial Coinfection in Critically Ill COVID-19 Patients
  4. Diagnosis and Management of Community-acquired Pneumonia: An Official American Thoracic Society Clinical Practice Guideline, 2025
  5. Intensive Care Medicine — Association of Plasma sRAGE Levels with Mortality Risk in ARDS: A Meta-Analysis of Individual Patient Data
  6. Guideline landscape and areas of agreement/controversy (2025–2026)
  7. Recent evidence on systemic inflammatory markers and short-term mortality
  8. Infectious Diseases Society of America (IDSA) Position Statement: Why IDSA Did Not Endorse the Community-Acquired Pneumonia Guidelines 2025 Update | Clinical Infectious Diseases | Oxford Academic

Original Source(s)

Association of Systemic Inflammatory Markers with 28-Day Mortality in Patients with Severe Pneumonia: A Retrospective Study from a Single Center

  • by Xingxing Chen, Weiqiang Huang, Wenjing Dai, Wei Zhang, Xiaofeng Zhong, Ming Hu

  • April 21, 2026

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