Risk factors for early mortality in haematological malignancy patients with pulmonary mucormycosis.
Risk factors for early mortality in haematological malignancy patients with pulmonary mucormycosis.
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DOI：
10.1111/myc.12101
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发表时间：
2014-01
期刊：
影响因子：
4.9
通讯作者：
Kontoyiannis DP
中科院分区：
文献类型：
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作者：
Lewis RE;Georgiadou SP;Sampsonas F;Chamilos G;Kontoyiannis DP
肺毛霉菌病（PM）是一种危及生命的机会性真菌病，临床演变多变，预后指标很少。在2000-2012年的75例连续血液学患者中分析了PM诊断时存在的不良结局的几个临床风险因素。将重要变量（P< 0.1）输入多变量考克斯-比例风险回归模型，调整基线APACHE II，以确定28天内死亡的独立风险因素。75例患者中有28例在4周随访内死亡。诊断时淋巴细胞计数< 100/mm 3（校正风险比4.0，1.7- 9.4，P = 0.01）和乳酸脱氢酶水平高（AHR 3.7，1.3- 10.2，P = 0.015）与APACHE II评分沿着是28天死亡率的独立预测因子。基于这3个基线变量的加权风险评分准确识别了28天时的非存活患者（受试者操作曲线下面积为0.87，0.77- 0.93，P < 0.001）。风险评分> 22的患者在诊断后28天内的死亡率高8倍（P< 0.0001），中位生存期为7天，而风险评分22的患者为28天。我们发现，APACHE II评分，严重的淋巴细胞减少症和高LDH水平在PM诊断的时间是快速疾病进展和死亡的独立标志物。
Pulmonary mucormycosis (PM) is a life‐threatening opportunistic mycosis with a variable clinical evolution and few prognostic markers for outcome assessment. Several clinical risk factors for poor outcome present at the diagnosis of PM were analyzed in 75 consecutive hematology patients from 2000–2012. Significant variables (P< 0.1) were entered into a multivariate Cox‐proportional hazard regression model adjusting for baseline APACHE II to identify independent risk factors for mortality within 28 days. Twenty‐eight of 75 patients died within 4‐week follow up. A lymphocyte count < 100/mm3at the time of diagnosis (adjusted hazard ratio 4.0, 1.7–9.4,P= 0.01) and high level of lactate dehydrogenase (AHR 3.7, 1.3–10.2,P= 0.015) were independent predictors along with APACHE II score for 28‐day mortality. A weighted risk score based on these 3 baseline variables accurately identified non‐surviving patients at 28 days (area under the receiver‐operator curve of 0.87, 0.77–0.93,P< 0.001). A risk score > 22 was associated with 8‐fold high rates of mortality (P< 0.0001) within 28 days of diagnosis and median survival of 7 days versus 28 days in patients with risk scores 22. We found that APACHE II score, severe lymphocytopenia and high LDH levels at the time of PM diagnosis were independent markers for rapid disease progression and death.
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影响因子：
20.3
作者：
Potenza, Leonardo;Vallerini, Daniela;Luppi, Mario
通讯作者：
Luppi, Mario
影响因子：
11.8
作者：
Spellberg, Brad;Ibrahim, Ashraf;Walsh, Thomas J.
通讯作者：
Walsh, Thomas J.
DOI：
10.1086/652768
发表时间：
2010-06-15
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Baddley JW;Andes DR;Marr KA;Kontoyiannis DP;Alexander BD;Kauffman CA;Oster RA;Anaissie EJ;Walsh TJ;Schuster MG;Wingard JR;Patterson TF;Ito JI;Williams OD;Chiller T;Pappas PG
通讯作者：
Pappas PG
影响因子：
1.8
作者：
Pagano, L.;Valentini, C. G.;Viviani, M.
通讯作者：
Viviani, M.
影响因子：
11.8
作者：
Upton, Arlo;Kirby, Katharine A.;Marr, Kieren A.
通讯作者：
Marr, Kieren A.