Joint modeling of longitudinal changes of pulse rate and body temperature with time to recovery of pneumonia patients under treatment: a prospective cohort study

Abstract

BackgroundPneumonia is the leading infectious cause of mortality worldwide and one of the most common lower respiratory tract infections that is contributing significantly to the burden of antibiotic consumption. The study aims to identify the determinants of the progress of pulse rate, body temperature and time to recovery of pneumonia patients.MethodA prospective cohort study design was used from Felege Hiwot referral hospital on 214 sampled pneumonia patients from March 01, 2022 up to May 31, 2022. The Kaplan–Meier survival estimate and Log-Rank test was used to compare the survival time. Joint model of bivariate longitudinal and time to event model was used to identify factors of longitudinal change of pulse rate and body temperature with time to recovery jointly.ResultAs the follow up time of pneumonia patient’s increase by one hour the average longitudinal change of pulse rate and body temperature were decreased by 0.4236 bpm and 0.0119 {C}^{0}. The average longitudinal change of pulse rate and body temperature of patients who lived in rural was 1.4602 bpm and 0.1550 {C}^{0} times less as compared to urban residence. Patients who had dangerous signs are significantly increased the average longitudinal change of pulse rate and body temperature by 2.042 bpm and 0.6031 {C}^{0} as compared to patients who had no dangerous signs. A patient from rural residence was 1.1336 times more likely to experience the event of recovery as compared to urban residence. The estimated values of the association parameter for pulse rate and body temperature were -0.4236 bpm and -0.0119 respectively, which means pulse rate and body temperature were negatively related with patients recovery time.ConclusionPulse rate and body temperature significantly affect the time to the first recovery of pneumonia patients who are receiving treatment. Age, residence, danger sign, comorbidity, baseline symptom and visiting time were the joint determinant factors for the longitudinal change of pulse rate, body temperature and time to recovery of pneumonia patients. The joint model approach provides precise dynamic predictions, widespread information about the disease transitions, and better knowledge of disease etiology.