Analysis of factors implicated in the outcomes of patients with invasive pulmonary aspergillosis
10.3760/cma.j.issn.1671-0282.2012.09.025
- VernacularTitle:侵袭性肺曲霉病患者预后因素分析
- Author:
Sicheng XU
;
Xunan DONG
;
Lijing DENG
;
Xinhong GUO
;
Xiaohong SANG
;
Lihua QIU
;
Bingxiu REN
- Publication Type:Journal Article
- Keywords:
Invasive pulmonary aspergillosis;
Fungal lung disease;
Immunosurpression;
Computed tomography scan;
Prognostic factors
- From:
Chinese Journal of Emergency Medicine
2012;21(9):1026-1031
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the factors implicated in the outcomes of patients with invasive pulmonary aspergillosis (IPA).Methods During a 5-year period,65 patients with IPA met the criteria set by the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG)in 2008 were retrospectively evaluated. The initial CT findings of eligible patients were reviewed by two senior radiologists who specialized in chest radiology.Patients were divided into the survivor (n =43 ) and non-survivor (n =22) groups according to their survival as long as 3 months after the diagnosis of IPA was made.An initial univariate analysis was used to screen variables that were related to prognosis,followed by a multivariate logistic regression analysis to examine these variables. Results Of the 65 IPA patients analyzed,23 (35％) had a proven diagnosis and 42 (65％) were probable ones.The univariate analysis showed that the rates of extra-pulmonary infection,uncontrolled underlying diseases and invasive mechanical ventilation were significantly different between the 3-month survival group and the non-survival group ( P ＜0.05,respectively),whereas chest CT findings,including air-space consolidation/massive consolidation,macronodules,infarct-like macronodules,halo signs, ground-glass opacities,small nodules,hypodense signs,cavities,crescent signs,small-airway findings,bronchial wall thickening/bronchiectasis,pleural effusion and hydro-pericardium, were not significantly different between the two groups (P ＞ O.05,respectively).Logistic regression analysis revealed that an uncontrolled underlying disease was the only independent predictor of 3-month mortality in patients with IPA (P =0.001,OR:O.024,95 ％ CI:O.003 ～0.223,B =- 3.714,SE =1.129,Wald =10.821 ). Conclusions An uncontrolled co-morbidity was the only independent predictor of mortality within 3 months in patients with IPA.The initial CT findings did not confer any informatioin of implication in predicting the outcomes of IPA patients.
