Skip to main content

Table 4 Risk factors for hospital mortality in 268 ICI patients receiving antifungal therapy in the China-SCAN study based only on patients who died in hospital or completed treatment and were discharged at their physician’s discretion

From: Initial therapeutic strategy of invasive candidiasis for intensive care unit patients: a retrospective analysis from the China-SCAN study

Variables Survivors
N = 139
Non-survivors
N = 99
P-value
Age, years 58.6 ± 20.6 66.0 ± 19.8 0.006
Gender, n (%)    0.259
 Male 91 (65.5) 72 (72.7)  
 Female 48 (34.5) 27 (27.3)  
Body weight, kg 62.2 ± 10.4 62.4 ± 11.0 0.891
APACHE II score on ICU admission 19.0 ± 8.9 22.5 ± 8.4 0.002
SOFA score on ICU admission 6.6 ± 3.5 7.9 ± 3.8 0.008
Underlying disease, n (%)
 Diabetic mellitus 25 (18.0) 28 (28.3) 0.081
 Chronic cardiac dysfunctiona 26 (18.7) 26 (26.3) 0.203
 Chronic obstructive pulmonary disease 16 (11.5) 15 (15.2) 0.439
 Chronic renal insufficiencyb 11 (7.9) 16 (16.2) 0.062
 Chronic hepatic insufficiencyc 4 (2.9) 7 (7.1) 0.208
 Solid tumor 22 (15.8) 25 (25.3) 0.098
 Haematological malignancy 1 (0.7) 2 (2.0) 0.572
Immune compromised, n (%)
 Immunosuppressant therapyd 4 (2.9) 6 (6.1) 0.327
 HIV infection - 1 (1.0) 0.416
 Neutropenia 1 (0.7) 2 (2.0) 0.572
Source of candidiasis, n (%)e
 Blood culture 135 (97.1) 96 (97.0) 0.999
 Other sterile site 5 (3.6) 5 (5.1) 0.745
Pathogenic Candida species, n (%)f    0.321
C. albicans 55 (39.6) 38 (38.4) 0.893
C.tropicalis 21 (15.1) 11 (11.1) 0.443
C.glabrata 15 (10.8) 18 (18.2) 0.128
C.parapsilosis 20 (14.4) 18 (18.2) 0.475
Initial antifungal therapy
 Strategies, n (%)    0.004
  empirical therapy 66 (47.5) 35 (35.4) 0.041
  pre-emptive therapy 37 (26.6) 35 (35.4) 0.155
  Targeted therapy 36 (25.9) 29 (29.3) 0.658
 Categories, n (%)g    0.348
  fluconazole 54 (38.8) 34 (34.3) 0.499
  caspofungin 34 (24.5) 21 (21.2) 0.640
  voriconazole 22 (15.8) 25 (25.3) 0.098
 Susceptibility, n (%)
  susceptible 122 (87.8) 89 (89.9) 0.682
  completely resistant 9 (6.5) 6 (6.1) 0.999
 Duration, days 8.0 (10.0) 6.0 (11.0) 0.428
 Drug Adjustment, n (%) 62 (44.6) 54 (54.5) 0.149
Procedures within 2 weeks prior to diagnosis, n (%)
 Life-sustaining treatments ≥ 24 h
  Invasive mechanical ventilation 109 (78.4) 87 (87.9) 0.084
  vasopressor 38 (27.3) 33 (33.3) 0.389
  Renal replacement therapy 7 (5.0) 12 (12.1) 0.055
 Catheterization, n (%)h
  central venous 113 (81.3) 87 (87.9) 0.210
  indwelling arterial 24 (17.8) 21 (21.9) 0.501
  drainage tube 53 (38.1) 38 (38.4) 0.999
  urethral 101 (73.2) 81 (81.8) 0.160
  Gastrointestinal dysfunction, n (%)i 79 (56.8) 54 (54.5) 0.791
  Total parenteral nutrition, n (%) 70 (50.4) 54 (54.5) 0.599
  Surgery, n (%) 60 (43.2) 35 (35.7) 0.283
  Abdominal 39 (28.1) 25 (25.3) 0.659
Procedures at diagnosis, n (%)
 APACHE II score 18.8 ± 8.5 22.7 ± 7.0 0.000
 SOFA score 6.4 ± 3.6 7.8 ± 3.8 0.003
 Vasopressor 37 (26.6) 39 (39.4) 0.048
Catheterization, n (%)j
 central venous 88 (64.2) 76 (77.6) 0.031
 indwelling arterial 20 (14.8) 13 (13.5) 0.850
 drainage tube 40 (29.6) 32 (34.0) 0.563
 urethral 97 (70.3) 79 (79.8) 0.132
Central venous catheter removed within 48 h after first positive sample obtained, n (%) 92 (66.2) 70 (70.7) 0.484
Drainage catheter removed within 48 h after first positive sample obtained, n (%) 19 (13.7) 8 (8.1) 0.216
Immunopotentiation therapy, n (%)k 55 (39.6) 51 (51.5) 0.085
  1. Continuous variables are expressed as the means ± SD or medians (IQR). All the other data are raw numbers (%)
  2. APACHE II Acute Physiology and Chronic Health Evaluation II, SOFA sequential organ failure assessment
  3. aAll patients corresponding to the NYHA standards of level II or higher
  4. bAll patients receiving long-term hemodialysis
  5. cAs described according to the APACHE II criteria: biopsy-proven cirrhosis and documented portal hypertension; episodes of past upper gastrointestinal bleeding attributed to portal hypertension; or prior episodes of hepatic failure/encephalopathy/coma
  6. dVariables included steroid therapy, which defined as >0.5 mg/(kg · day)−1 prednisone over 1 month (n = 7), cancer chemotherapy (n = 6), post-solid organ transplant immunosuppression (n = 1), allogeneic bone marrow transplantation or allogeneic haematopoietic stem cell transplantation (n = 1), and tumor necrosis factor therapy (n = 1) within 3 months prior to study entry
  7. eDiagnostic confirmation of other sterile sites was based on positive fluid culture from a normally sterile site (cerebral spinal fluid, ascitic fluid or pleural fluid) in 10 (3.7%) cases and on histopathology in one patient (0.3%); Diagnosis was confirmed by candidaemia combined with positive culture from a normally sterile site in 3 (1.1%) cases
  8. f C. tropicalis, C. glabrata, and C. parapsilosis were the most prevalent non-C. albicans species isolated, which were identified in >98% of samples
  9. gFirst-line treatment comprised a single agent in 264/268 (98.5%) patients, most commonly fluconazole (101/268;37.7%), caspofungin (64/268; 23.9%), and voriconazole (49/268; 18.3%)
  10. hVariables included patients who required treatments were catheterized within 2 weeks of the first positive sample no matter the catheter was removed or not before diagnosis
  11. iVariable included haemorrhage, food intolerance, perforation, surgery, acalculouscholecystitis or intra-abdominal hypertension
  12. jAll patients who were catheterized when the first positive samples were collected
  13. kVariable included immunoglobulin and thymosin