1693. Risk Factors Associated with Mortality of Invasive Aspergillosis in King Chulalongkorn Memorial Hospital

Abstract

BackgroundInvasive aspergillosis is the serious fungal infection that often found in the immunocompromised host such as hematologic malignancy, bone marrow transplantation, organ transplantation, and patient who received chemotherapy. Nowadays the patient who diagnosed with invasive aspergillosis has a high mortality rate of 50–60%. There were some studies about the risk factor of mortality of invasive aspergillosis but most of them were not in Thailand. The objective of this study was to identify risk factors related to mortality and the mortality rate of invasive aspergillosis in King Chulalongkorn Memorial Hospital.MethodsThe retrospective study by collected and analyzed the data from medical record by ICD 10, between 1 January 2012 and 30 October 2017.ResultsTotal patients were 176 patients; the mortality rate of invasive aspergillosis patient was 46%. The most common underlying condition was AML (27.8%). The risk of invasive aspergillosis was prolonged neutropenia (31.3%), prolonged corticosteroid therapy 27.8% and induction phase chemotherapy 22.7%. The most infection site was the pulmonary system at 80.1%, sinus 13.6%, and CNS 5.7%. The significant factor which affect the mortality rate was cirrhosis [HR 4.21, 95% CI 1.46–11.69, P = 0.008], HIV infection/AIDS [HR 3.24, 95% CI 1.03–10.24, P = 0.045], tracheal infection [HR 21.81, 95% CI 1.48–320.41, P = 0.025] and empirical treatment with itraconazole [HR 11.65, 95% CI 3.14–43.17, P ≤ 0.001]ConclusionThe Risk factors associated with mortality of invasive aspergillosis in King Chulalongkorn Memorial Hospital was cirrhosis, HIV infection/AIDS, tracheal infection, and the empirical treatment with itraconazole. The overall mortality rate of invasive aspergillosis was 46%. Disclosures All authors: No reported disclosures.