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:	Chien-Ming Chao, Chih-Cheng Lai, Hsuan-Fu Ou, Chung-Han Ho, Khee-Siang Chan, Chun-Chieh Yang, Chin-Ming Chen, Wen-Liang Yu
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	aspergillosis influenza outcome intensive care unit mortality Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/2c3928307c7344c19b3734cc6adcd3c4
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spelling	oai:doaj.org-article:2c3928307c7344c19b3734cc6adcd3c42021-11-25T18:05:47ZThe Impacts of Aspergillosis on Outcome, Burden and Risks for Mortality in Influenza Patients with Critical Illness10.3390/jof71109222309-608Xhttps://doaj.org/article/2c3928307c7344c19b3734cc6adcd3c42021-10-01T00:00:00Zhttps://www.mdpi.com/2309-608X/7/11/922https://doaj.org/toc/2309-608XPrevious 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 (<i>n</i> = 40), group 2 (<i>n</i> = 50), and group 3 (<i>n</i> = 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%), <i>p</i> < 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.Chien-Ming ChaoChih-Cheng LaiHsuan-Fu OuChung-Han HoKhee-Siang ChanChun-Chieh YangChin-Ming ChenWen-Liang YuMDPI AGarticleaspergillosisinfluenzaoutcomeintensive care unitmortalityBiology (General)QH301-705.5ENJournal of Fungi, Vol 7, Iss 922, p 922 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	aspergillosis influenza outcome intensive care unit mortality Biology (General) QH301-705.5
spellingShingle	aspergillosis influenza outcome intensive care unit mortality Biology (General) QH301-705.5 Chien-Ming Chao Chih-Cheng Lai Hsuan-Fu Ou Chung-Han Ho Khee-Siang Chan Chun-Chieh Yang Chin-Ming Chen Wen-Liang Yu The Impacts of Aspergillosis on Outcome, Burden and Risks for Mortality in Influenza Patients with Critical Illness
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 (<i>n</i> = 40), group 2 (<i>n</i> = 50), and group 3 (<i>n</i> = 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%), <i>p</i> < 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.
format	article
author	Chien-Ming Chao Chih-Cheng Lai Hsuan-Fu Ou Chung-Han Ho Khee-Siang Chan Chun-Chieh Yang Chin-Ming Chen Wen-Liang Yu
author_facet	Chien-Ming Chao Chih-Cheng Lai Hsuan-Fu Ou Chung-Han Ho Khee-Siang Chan Chun-Chieh Yang Chin-Ming Chen Wen-Liang Yu
author_sort	Chien-Ming Chao
title	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_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_sort	impacts of aspergillosis on outcome, burden and risks for mortality in influenza patients with critical illness
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/2c3928307c7344c19b3734cc6adcd3c4
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The Impacts of Aspergillosis on Outcome, Burden and Risks for Mortality in Influenza Patients with Critical Illness

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