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Table 4 Predictors of mortality within 42 days of initiation of IA therapy in patients with hematologic malignancy and aspergillosis

From: Treating invasive aspergillosis in patients with hematologic malignancy: diagnostic-driven approach versus empiric therapies

Variables Univariate Multivariate analysis
Dead
(n = 132)
N (%)
Alive
(n = 208)
N (%)
p-value HR (95% CI) p-value
Age (years), median (range) 50 (16–80) 56 (14–86) 0.07  
Gender, male 84 (64) 119 (57) 0.24  
Diagnosis of invasive aspergillosis    0.001   0.023
 Definite 54 (41) 50/207 (24)   1.5 (1.1, 2.2)  
 Probable 78 (59) 157/207 (76)   Referent  
Type of IA infection a    0.16   0.007
 Invasive pulmonary infection 111 (84) 174 (84)   3.3 (1.5, 7.2) (0.003)
 Disseminated infection 13 (10) 12 (6)   4.0 (1.6, 10.3) (0.003)
 Localized or sinus infection 8 (6) 22 (11)   Referent  
Type of cancer    0.05  
 Leukemia 106/131 (81) 148/205 (72)    
 Lymphoma 23/131 (18) 43/205 (21)    
 Myeloma 2/131 (2) 14/205 (7)    
Transplantation within 1 year prior to infection 41/131 (31) 91 (44) 0.022 0.60 (0.41, 0.88) 0.008
Type of transplantation within prior year    0.06   
 Allogeneic transplant 39/41 (95) 74/91 (81)    
 Autologous transplant 2/41 (8) 17/91 (19)    
Graft vs Host Disease (GVHD) 29/39 (74) 53/74 (72) 0.76   
Neutropenia (< 500 ANC) at onset of IA 79/130 (61) 76/199 (38) < .0001  
Persistent neutropenia 59/130 (45) 63/179 (35) 0.07  
Received immunotherapy 92 (70) 108/205 (53) 0.002  
Received WBC transfusion 31 (23) 24/206 (12) 0.004  
Year of IA diagnosis/treatment    < .0001  
 1993–2004 99 (75) 87 (42)    
 2005–2016 33 (25) 121 (58)    
Prophylactic antifungal treatment prior to infection 36 (27) 76/207 (37) 0.07 0.61 (0.41, 0.90) 0.012
Breakthrough 29/36 (81) 69/75 (92) 0.11   
Primary therapy strategy    < .0001   < .0001
 Diagnostic-driven therapy with voriconazole 2 (2) 42 (20)   Referent  
 Empiric antifungal therapy without voriconazole 123 (93) 97 (47)   18.0 (4.4, 73.2) (< .0001)
 Empiric antifungal therapy with voriconazole 7 (5) 69 (33)   2.2 (0.5, 10.6) (0.33)
  1. IA = Invasive aspergillosis; WBC = White blood cell; HR = Hazard ratio; 95% CI = 95% Confidence interval
  2. aAll patients with more than one types of IA infections in this study had invasive pulmonary infection and were included in invasive pulmonary infection category in this analysis