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Impact of invasive pulmonary aspergillosis in critically Ill surgical patients with or without solid organ transplantation

Background: Critically ill patients, especially those who have undergone solid organ transplantation (SOT), are at risk of invasive pulmonary aspergillosis (IPA). The outcome relevance of adequately treated putative IPA (pIPA) is a matter of debate. The aim of this study is to assess the outcome rel...

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Main Authors: Dubler, Simon (Author) , Etringer, Michael (Author) , Weigand, Markus A. (Author) , Brenner, Thorsten (Author) , Zimmermann, Stefan (Author) , Schnitzler, Paul (Author) , Budeus, Bettina (Author) , Rengier, Fabian (Author) , Kalinowska, Paulina (Author) , Hoo, Yuan Lih (Author) , Lichtenstern, Christoph (Author)
Format: Article (Journal)
Language:English
Published: 4 May 2023
In: Journal of Clinical Medicine
Year: 2023, Volume: 12, Issue: 9, Pages: 1-12
ISSN:2077-0383
DOI:10.3390/jcm12093282
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/jcm12093282
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2077-0383/12/9/3282
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Author Notes:Simon Dubler, Michael Etringer, Markus A. Weigand, Thorsten Brenner, Stefan Zimmermann, Paul Schnitzler, Bettina Budeus, Fabian Rengier, Paulina Kalinowska, Yuan Lih Hoo and Christoph Lichtenstern
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Summary:Background: Critically ill patients, especially those who have undergone solid organ transplantation (SOT), are at risk of invasive pulmonary aspergillosis (IPA). The outcome relevance of adequately treated putative IPA (pIPA) is a matter of debate. The aim of this study is to assess the outcome relevance of pIPA in a cohort of critically ill patients with and without SOT. Methods: Data from 121 surgical critically ill patients with pIPA (n = 30) or non-pIPA (n = 91) were included. Cox regression analysis was used to identify risk factors for mortality and unfavourable outcomes after 28 and 90 days. Results: Mortality rates at 28 days were similar across the whole cohort of patients (pIPA: 31% vs. non-pIPA: 27%) and did not differ in the subgroup of patients after SOT (pIPA: 17% vs. non-pIPA: 22%). A higher Sequential Organ Failure Assessment (SOFA) score and evidence of bacteraemia were identified as risk factors for mortality and unfavourable outcome, whereas pIPA itself was not identified as an independent predictor for poor outcomes. Conclusions: Adequately treated pIPA did not increase the risk of death or an unfavourable outcome in this mixed cohort of critically ill patients with or without SOT, whereas higher disease severity and bacteraemia negatively affected the outcome.
Item Description:Gesehen am 19.06.2023
Physical Description:Online Resource
ISSN:2077-0383
DOI:10.3390/jcm12093282

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