Abstract Background This study aimed to evaluate the prognostic value of T helper 1/T helper 2/T helper 17 (Th1/Th2/Th17)-related cytokines for predicting 30-day mortality in patients with severe pneumonia. Methods This retrospective cohort study included 106 patients with severe pneumonia admitted between June 2020 and July 2023. Serum levels of Th1/Th2/Th17 cytokines, procalcitonin (PCT), and high-sensitivity C-reactive protein (hs-CRP) were measured at admission. Disease severity was stratified using the Pneumonia Severity Index (PSI) and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores. Thirty-day in-hospital clinical outcomes were recorded. Multivariable logistic regression was used to identify independent prognostic factors, and receiver operating characteristic (ROC) curves were constructed to evaluate predictive performance. Results Nonsurvivors had significantly higher serum levels of IL-6, IL-10, and IL-17A compared to survivors (all P < 0.05). Multivariable analysis identified elevated APACHE II score (OR = 1.305), PSI score (OR = 1.093), and IL-6 level (OR = 1.054) as independent predictors of 30-day in-hospital mortality (all P < 0.05). ROC analysis yielded areas under the curves (AUCs) of 0.862 for IL-6, 0.826 for APACHE II, 0.872 for PSI, and 0.963 for the combined model, confirming the superior predictive accuracy of the integrated model. Conclusion Elevated IL-6, IL-10, and IL-17A levels were associated with poor prognosis in severe pneumonia, and IL-6 was an independent predictor of mortality. Combining IL-6 with PSI and APACHE II scores significantly improved prognostic discrimination, providing a clinically applicable tool for early risk stratification and management optimization in patients with severe pneumonia.
Zhang et al. (Fri,) studied this question.