Predictors of adverse outcome in cancer patients with candidemia
Predictors of adverse outcome in cancer patients with candidemia
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DOI：
10.1016/s0002-9343(98)00030-8
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发表时间：
1998-03-01
影响因子：
5.9
通讯作者：
Vartivarian, S
中科院分区：
文献类型：
--
作者：
Anaissie, EJ;Rex, JH;Vartivarian, S
背景技术背景：许多因素，包括疾病的严重程度，中性粒细胞减少，静脉导管管理和药物治疗可能会影响癌症患者的念珠菌血症的结果。D.回顾性分析了安德森癌症中心1988年1月1日至1992年12月31日期间发生一次或多次念珠菌血培养阳性的患者。491例念珠菌血症被确定，其中476例有完整的医疗记录，这是详细reviewed.Results：3个月的随访，52%的患者死亡。中性粒细胞减少、较高的APACHE III评分和内脏播散与不良预后相关。根据疾病严重程度调整后，氟康唑和阿替霉素B治疗的治愈率相似。中心静脉导管的交换与预后的适度改善相关。结论：已经确定了几个影响癌症患者念珠菌血症结局的因素。这些因素可能与念珠菌血症癌症患者的临床管理和治疗试验的设计有关。
BACKGROUND: Many factors, including severity of illness, neutropenia, intravenous catheter management, and drug therapy may affect the outcome of candidemia in cancer patients.METHODS: The records of all patients at M. D. Anderson Cancer Center who developed one or more positive blood cultures for Candida spp between January 1, 1988, and December 31, 1992, were retrospectively reviewed. Four hundred ninety one episodes of candidemia were identified, for which 476 had complete medical records, which were reviewed in detail.RESULTS: By 3-month follow-up, 52% of the patients had died. Neutropenia, higher APACHE III score, and visceral dissemination were associated with poor prognosis. Cure rates, adjusted for severity of illness, were similar for fluconazole and amphotericin B treatment. Exchange of central venous catheters was associated with a modest improvement in prognosis.CONCLUSION: Several factors that influence the outcome of candidemia in cancer patients have been identified. These factors may be relevant for the clinical management of cancer patients with candidemia, and for the design of therapeutic trials.