Fungal "colonisation" is associated with increased mortality in medical intensive care unit patients with liver cirrhosis
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Fungal "colonisation" is associated with increased mortality in medical intensive care unit patients with liver cirrhosis. / Lahmer, Tobias; Messer, Marlena; Mayr, Ulrich; Saugel, Bernd; Noe, Sebastian; Schultheiss, Caroline; Thies, Philipp; Spinner, Christoph; Nennstiel, Simon; Schwerdtfeger, Christiane; Phillip, Veit; Schmid, Roland M; Huber, Wolfgang.
In: MYCOPATHOLOGIA, Vol. 179, No. 1-2, 01.02.2015, p. 63-71.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Fungal "colonisation" is associated with increased mortality in medical intensive care unit patients with liver cirrhosis
AU - Lahmer, Tobias
AU - Messer, Marlena
AU - Mayr, Ulrich
AU - Saugel, Bernd
AU - Noe, Sebastian
AU - Schultheiss, Caroline
AU - Thies, Philipp
AU - Spinner, Christoph
AU - Nennstiel, Simon
AU - Schwerdtfeger, Christiane
AU - Phillip, Veit
AU - Schmid, Roland M
AU - Huber, Wolfgang
PY - 2015/2/1
Y1 - 2015/2/1
N2 - OBJECTIVES: Patients with liver cirrhosis are at increased risk for fungal infections. However, distinction of fungal colonisation (FC) and invasive mycoses is difficult. Aim of this study was to analyse the impact of FC on mortality of cirrhotic ICU-patients.METHODS: Retrospective mortality analysis of a prospectively maintained database on 120 cirrhotic patients with and without FC. Comparison to 120 noncirrhotic controls matched for APACHE-II (24.9 ± 3.7 vs. 25.0 ± 2.6; p = 0.263).RESULTS: About 69/120 (58%) of patients with cirrhosis had FC. These patients had significantly higher APACHE-II score and mortality compared to cirrhotic patients without FC (27 ± 3 vs. 23 ± 4, p < 0.001; 78 vs. 35%, p < 0.001). In multivariate analysis, FC was independently (p = 0.047) associated to mortality. Mortality of noncirrhotic patients with FC (14/31; 45.2%) was not different to noncirrhotic controls without FC [28/89 (31.2%; p = 0.168)]. Similarly, in multivariate analysis of noncirrhotics, APACHE-II (p < 0.001), but not FC, was independently associated to mortality. Multiple regression analysis of all 240 cirrhotic and noncirrhotic patients demonstrated that APACHE-II (p < 0.001), cirrhosis (p = 0.001) and FC (p = 0.049) were independently associated with mortality.CONCLUSION: Fungal "colonisation" is independently associated to mortality in cirrhotic ICU-patients. Early antimycotic therapy should be considered in critically ill cirrhotic patients with FC.
AB - OBJECTIVES: Patients with liver cirrhosis are at increased risk for fungal infections. However, distinction of fungal colonisation (FC) and invasive mycoses is difficult. Aim of this study was to analyse the impact of FC on mortality of cirrhotic ICU-patients.METHODS: Retrospective mortality analysis of a prospectively maintained database on 120 cirrhotic patients with and without FC. Comparison to 120 noncirrhotic controls matched for APACHE-II (24.9 ± 3.7 vs. 25.0 ± 2.6; p = 0.263).RESULTS: About 69/120 (58%) of patients with cirrhosis had FC. These patients had significantly higher APACHE-II score and mortality compared to cirrhotic patients without FC (27 ± 3 vs. 23 ± 4, p < 0.001; 78 vs. 35%, p < 0.001). In multivariate analysis, FC was independently (p = 0.047) associated to mortality. Mortality of noncirrhotic patients with FC (14/31; 45.2%) was not different to noncirrhotic controls without FC [28/89 (31.2%; p = 0.168)]. Similarly, in multivariate analysis of noncirrhotics, APACHE-II (p < 0.001), but not FC, was independently associated to mortality. Multiple regression analysis of all 240 cirrhotic and noncirrhotic patients demonstrated that APACHE-II (p < 0.001), cirrhosis (p = 0.001) and FC (p = 0.049) were independently associated with mortality.CONCLUSION: Fungal "colonisation" is independently associated to mortality in cirrhotic ICU-patients. Early antimycotic therapy should be considered in critically ill cirrhotic patients with FC.
U2 - 10.1007/s11046-014-9825-6
DO - 10.1007/s11046-014-9825-6
M3 - SCORING: Journal article
C2 - 25348847
VL - 179
SP - 63
EP - 71
JO - MYCOPATHOLOGIA
JF - MYCOPATHOLOGIA
SN - 0301-486X
IS - 1-2
ER -