Show simple item record 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
dc.coverage.spatial United States 2011-06-21T17:27:21Z 2010-06-15
dc.identifier.citation Clin Infect Dis, 2010, 50 (12), pp. 1559 - 1567
dc.description.abstract BACKGROUND: Invasive aspergillosis (IA) is an important cause of morbidity and mortality in hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) recipients. The purpose of this study was to evaluate factors associated with mortality in transplant patients with IA. METHODS: Transplant patients from 23 US centers were enrolled from March 2001 to October 2005 as part of the Transplant Associated Infection Surveillance Network. IA cases were identified prospectively in this cohort through March 2006, and data were collected. Factors associated with 12-week all-cause mortality were determined by logistic regression analysis and Cox proportional hazards regression. RESULTS: Six-hundred forty-two cases of proven or probable IA were evaluated, of which 317 (49.4%) died by the study endpoint. All-cause mortality was greater in HSCT patients (239 [57.5%] of 415) than in SOT patients (78 [34.4%] of 227; P<.001). Independent poor prognostic factors in HSCT patients were neutropenia, renal insufficiency, hepatic insufficiency, early-onset IA, proven IA, and methylprednisolone use. In contrast, white race was associated with decreased risk of death. Among SOT patients, hepatic insufficiency, malnutrition, and central nervous system disease were poor prognostic indicators, whereas prednisone use was associated with decreased risk of death. Among HSCT or SOT patients who received antifungal therapy, use of an amphotericin B preparation as part of initial therapy was associated with increased risk of death. CONCLUSIONS: There are multiple variables associated with survival in transplant patients with IA. Understanding these prognostic factors may assist in the development of treatment algorithms and clinical trials.
dc.format.extent 1559 - 1567
dc.language eng
dc.language.iso en_US en_US
dc.relation.ispartof Clin Infect Dis
dc.relation.isversionof 10.1086/652768
dc.subject Adult
dc.subject Antifungal Agents
dc.subject Aspergillosis
dc.subject Cohort Studies
dc.subject Female
dc.subject Hematopoietic Stem Cell Transplantation
dc.subject Humans
dc.subject Male
dc.subject Middle Aged
dc.subject Organ Transplantation
dc.subject Postoperative Complications
dc.subject Risk Factors
dc.title Factors associated with mortality in transplant patients with invasive aspergillosis.
dc.title.alternative en_US
dc.type Journal Article
dc.description.version Version of Record en_US 2010-6-15 en_US
duke.description.endpage 1567 en_US
duke.description.issue 12 en_US
duke.description.startpage 1559 en_US
duke.description.volume 50 en_US
dc.relation.journal Clinical Infectious Diseases en_US
pubs.issue 12
pubs.organisational-group /Duke
pubs.organisational-group /Duke/School of Medicine
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Medicine
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Medicine/Medicine, Infectious Diseases
pubs.organisational-group /Duke/School of Medicine/Clinical Science Departments/Pathology
pubs.publication-status Published
pubs.volume 50
dc.identifier.eissn 1537-6591

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