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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
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BMC Infectious Diseases

ISSN: 1471-2334

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