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The Impacts of Aspergillosis on Outcome, Burden and Risks for Mortality in Influenza Patients with Critical Illness

Previous studies have revealed higher mortality rates in patients with severe influenza who are coinfected with invasive pulmonary aspergillosis (IPA) than in those without IPA coinfection; nonetheless, the clinical impact of IPA on economic burden and risk factors for mortality in critically ill in...

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Autores principales: Chao, Chien-Ming, Lai, Chih-Cheng, Ou, Hsuan-Fu, Ho, Chung-Han, Chan, Khee-Siang, Yang, Chun-Chieh, Chen, Chin-Ming, Yu, Wen-Liang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8620692/
https://www.ncbi.nlm.nih.gov/pubmed/34829211
http://dx.doi.org/10.3390/jof7110922
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author Chao, Chien-Ming
Lai, Chih-Cheng
Ou, Hsuan-Fu
Ho, Chung-Han
Chan, Khee-Siang
Yang, Chun-Chieh
Chen, Chin-Ming
Yu, Wen-Liang
author_facet Chao, Chien-Ming
Lai, Chih-Cheng
Ou, Hsuan-Fu
Ho, Chung-Han
Chan, Khee-Siang
Yang, Chun-Chieh
Chen, Chin-Ming
Yu, Wen-Liang
author_sort Chao, Chien-Ming
collection PubMed
description Previous studies have revealed higher mortality rates in patients with severe influenza who are coinfected with invasive pulmonary aspergillosis (IPA) than in those without IPA coinfection; nonetheless, the clinical impact of IPA on economic burden and risk factors for mortality in critically ill influenza patients remains undefined. The study was retrospectively conducted in three institutes. From 2016 through 2018, all adult patients with severe influenza admitted to an intensive care unit (ICU) were identified. All patients were classified as group 1, patients with concomitant severe influenza and IPA; group 2, severe influenza patients without IPA; and group 3, severe influenza patients without testing for IPA. Overall, there were 201 patients enrolled, including group 1 (n = 40), group 2 (n = 50), and group 3 (n = 111). Group 1 patients had a significantly higher mortality rate (20/40, 50%) than that of group 2 (6/50, 12%) and group 3 (18/11, 16.2%), p < 0.001. The risk factors for IPA occurrence were solid cancer and prolonged corticosteroid use in ICU of >5 days. Group 1 patients had significantly longer hospital stay and higher medical expenditure than the other two groups. The risk factors for mortality in group 1 patients included patients’ Charlson comorbidity index, presenting APACHE II score, and complication of severe acute respiratory distress syndrome. Overall, IPA has a significant adverse impact on the outcome and economic burden of severe influenza patients, who should be promptly managed based on risk host factors for IPA occurrence and mortality risk factors for coinfection with both diseases.
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spelling pubmed-86206922021-11-27 The Impacts of Aspergillosis on Outcome, Burden and Risks for Mortality in Influenza Patients with Critical Illness Chao, Chien-Ming Lai, Chih-Cheng Ou, Hsuan-Fu Ho, Chung-Han Chan, Khee-Siang Yang, Chun-Chieh Chen, Chin-Ming Yu, Wen-Liang J Fungi (Basel) Article Previous studies have revealed higher mortality rates in patients with severe influenza who are coinfected with invasive pulmonary aspergillosis (IPA) than in those without IPA coinfection; nonetheless, the clinical impact of IPA on economic burden and risk factors for mortality in critically ill influenza patients remains undefined. The study was retrospectively conducted in three institutes. From 2016 through 2018, all adult patients with severe influenza admitted to an intensive care unit (ICU) were identified. All patients were classified as group 1, patients with concomitant severe influenza and IPA; group 2, severe influenza patients without IPA; and group 3, severe influenza patients without testing for IPA. Overall, there were 201 patients enrolled, including group 1 (n = 40), group 2 (n = 50), and group 3 (n = 111). Group 1 patients had a significantly higher mortality rate (20/40, 50%) than that of group 2 (6/50, 12%) and group 3 (18/11, 16.2%), p < 0.001. The risk factors for IPA occurrence were solid cancer and prolonged corticosteroid use in ICU of >5 days. Group 1 patients had significantly longer hospital stay and higher medical expenditure than the other two groups. The risk factors for mortality in group 1 patients included patients’ Charlson comorbidity index, presenting APACHE II score, and complication of severe acute respiratory distress syndrome. Overall, IPA has a significant adverse impact on the outcome and economic burden of severe influenza patients, who should be promptly managed based on risk host factors for IPA occurrence and mortality risk factors for coinfection with both diseases. MDPI 2021-10-29 /pmc/articles/PMC8620692/ /pubmed/34829211 http://dx.doi.org/10.3390/jof7110922 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chao, Chien-Ming
Lai, Chih-Cheng
Ou, Hsuan-Fu
Ho, Chung-Han
Chan, Khee-Siang
Yang, Chun-Chieh
Chen, Chin-Ming
Yu, Wen-Liang
The Impacts of Aspergillosis on Outcome, Burden and Risks for Mortality in Influenza Patients with Critical Illness
title The Impacts of Aspergillosis on Outcome, Burden and Risks for Mortality in Influenza Patients with Critical Illness
title_full The Impacts of Aspergillosis on Outcome, Burden and Risks for Mortality in Influenza Patients with Critical Illness
title_fullStr The Impacts of Aspergillosis on Outcome, Burden and Risks for Mortality in Influenza Patients with Critical Illness
title_full_unstemmed The Impacts of Aspergillosis on Outcome, Burden and Risks for Mortality in Influenza Patients with Critical Illness
title_short The Impacts of Aspergillosis on Outcome, Burden and Risks for Mortality in Influenza Patients with Critical Illness
title_sort impacts of aspergillosis on outcome, burden and risks for mortality in influenza patients with critical illness
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8620692/
https://www.ncbi.nlm.nih.gov/pubmed/34829211
http://dx.doi.org/10.3390/jof7110922
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