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Introduction <p>Pneumocystis jirovecii pneumonia (PJP) is one of the leading causes of mortality in kidney transplant recipients. Identifying risk factors for mortality in high-risk patients is essential for developing timely and proactive treatment strategies.</p> Materials and Methods <p>We conducted a retrospective analysis of clinical data from kidney transplant recipients who developed PJP progressing to acute respiratory distress syndrome. Baseline patient demographics, laboratory parameters on admission, and especially absolute lymphocyte count (ALC) levels within the first week of hospitalization were collected, along with follow-up data on patient outcomes. We analyzed ALC trajectory to define persistent lymphopenia and employed logistic regression to identify predictors of all-cause in-hospital mortality. A clinical prediction model was subsequently developed and evaluated using a range of performance metrics.</p> Results <p>Based on clinical indicators observed after admission, we defined persistent lymphopenia as an ALC below 400/μL for at least four consecutive days. In-hospital mortality was significantly higher in patients with persistent lymphopenia. Logistic regression analysis identified persistent lymphopenia, the C-reactive protein to albumin ratio, and the PaO₂/FiO₂ ratio as significant risk factors for in-hospital mortality. The clinical prediction model constructed from these variables exhibited excellent diagnostic performance and clinical applicability.</p> Conclusion <p>Persistent lymphopenia is a significant risk factor for patient mortality, and the clinical prediction model based on this factor demonstrates good diagnostic performance and clinical applicability.</p>

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The Development of a Prediction Model for In-Hospital Mortality of Pneumocystis Jirovecii Pneumonia among Kidney Transplant Recipients Based on the Trajectory of Absolute Lymphocyte Count

  • 期刊论文

  • 发表日期：

    2025年10月29日

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  • Yang Wang,
  • Lixuan Lou,
  • Yang Cong,
  • Chunni Huang,
  • Yuchao Zhou,
  • Shutian Xu,
  • Mingzhu Zheng,
  • Shijun Li

摘要

Introduction

Pneumocystis jirovecii pneumonia (PJP) is one of the leading causes of mortality in kidney transplant recipients. Identifying risk factors for mortality in high-risk patients is essential for developing timely and proactive treatment strategies.

Materials and Methods

We conducted a retrospective analysis of clinical data from kidney transplant recipients who developed PJP progressing to acute respiratory distress syndrome. Baseline patient demographics, laboratory parameters on admission, and especially absolute lymphocyte count (ALC) levels within the first week of hospitalization were collected, along with follow-up data on patient outcomes. We analyzed ALC trajectory to define persistent lymphopenia and employed logistic regression to identify predictors of all-cause in-hospital mortality. A clinical prediction model was subsequently developed and evaluated using a range of performance metrics.

Results

Based on clinical indicators observed after admission, we defined persistent lymphopenia as an ALC below 400/μL for at least four consecutive days. In-hospital mortality was significantly higher in patients with persistent lymphopenia. Logistic regression analysis identified persistent lymphopenia, the C-reactive protein to albumin ratio, and the PaO₂/FiO₂ ratio as significant risk factors for in-hospital mortality. The clinical prediction model constructed from these variables exhibited excellent diagnostic performance and clinical applicability.

Conclusion

Persistent lymphopenia is a significant risk factor for patient mortality, and the clinical prediction model based on this factor demonstrates good diagnostic performance and clinical applicability.