Universität zu Köln

Koehler, Philipp ORCID: 0000-0002-7386-7495, Salmanton-Garcia, Jon ORCID: 0000-0002-6766-8297, Graefe, Stefanie K., Koehler, Felix C., Mellinghoff, Sibylle C., Seidel, Danila, Steinbach, Angela and Cornely, Oliver A. (2019). Baseline predictors influencing the prognosis of invasive aspergillosis in adults. Mycoses, 62 (8). S. 651 - 659. HOBOKEN: WILEY. ISSN 1439-0507

Full text not available from this repository.

Abstract

Invasive aspergillosis (IA) is a serious hazard to haematological and critical care patients. Impactful risk factors for developing IA have been characterised; however, systematic analysis of baseline prognostic factors for treatment course of IA is missing. To understand prognostic variables, we analysed original articles identifying baseline factors that predict treatment outcome in patients with IA. PubMed database was searched for publications since database inception until May 2018. Inclusion criteria were published baseline prognostic factors present at the diagnosis of IA. In total, 58 studies from 267 centres reported 7320 patients with IA and 40 different predictors. Unfavourable predictors in medical history were kidney (7.4%, 10/136) and liver failure (3.7%, 5/136), ICU admission (3.7%, 5/136) and uncontrolled underlying disease (3.7%, 5/136). Regarding state of immunosuppression, negative outcome predictors were prolonged neutropenia (12.5%, 17/136), corticosteroid treatment (8.1%, 11/136) and graft-vs-host disease (3.7%, 5/136). On the pathogen side, relevant predictors were galactomannan positivity (8.1%, 11/136), Aspergillus terreus infection (2.2%, 3/136) and lack of amphotericin B susceptibility (1.5%, 2/136). IA-specific predictors were disseminated disease (5.1%, 7/136) and CNS involvement (2.9%, 4/136). Imaging results associated with negative outcome were multiple consolidations (2.9%, 4/136), bipulmonary lesions (2.2%, 3/136) and pleural effusion (2.2%, 3/136). At diagnosis of IA, most frequently identified predictors of outcome were neutropenia, corticosteroid use, elevated galactomannan, renal failure and disseminated disease. The predictors may be used to identify patients at high risk for treatment failure and to stratify neglected patient groups for clinical trials.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Koehler, Philipp UNSPECIFIED orcid.org/0000-0002-7386-7495 UNSPECIFIED Salmanton-Garcia, Jon UNSPECIFIED orcid.org/0000-0002-6766-8297 UNSPECIFIED Graefe, Stefanie K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Koehler, Felix C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mellinghoff, Sibylle C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seidel, Danila UNSPECIFIED UNSPECIFIED UNSPECIFIED Steinbach, Angela UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-134120
DOI:	10.1111/myc.12926
Journal or Publication Title:	Mycoses
Volume:	62
Number:	8
Page Range:	S. 651 - 659
Date:	2019
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1439-0507
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STEM-CELL TRANSPLANTATION; LIPOSOMAL AMPHOTERICIN-B; PULMONARY ASPERGILLOSIS; RISK-FACTORS; NEUTROPENIC PATIENTS; COMPUTED-TOMOGRAPHY; BRONCHOALVEOLAR LAVAGE; CLINICAL PRESENTATION; GALACTOMANNAN INDEX; HEMATOLOGY PATIENTS Multiple languages Dermatology; Mycology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13412