Abstract
Bloodstream fungal infections have a high mortality rate. There is little data about the long-term mortality rate of fungaemia.This study aimed to explore the mortality of fungaemia and the influencing factors associated with death. In total, 204 intensive care unit (ICU) patients with fungaemia from Multi-parameter Intelligent Monitoring in Intensive Care-III (MIMIC-III) Database were studied. Age, gender, major underlying diseases, data about vital signs and blood test results were analysed to identify the predictors of the mortality and prognosis of fungaemia in ICU patients. Cox regression models were constructed, together with Kaplan-Meier survival curves. The 30-day, 1-year, 2-year, 3-year and 4-year mortality rates were 41.2%, 62.3%, 68.1%, 72.5% and 75%, respectively. Age (P ＜ 0.001, OR = 1.530; P ＜ 0.001, OR = 1.485)，serum bilirubin (P = 0.016, OR = 2.125；P = 0.001, OR = 1.748) and international normalised ratio (INR) (P = 0.001, OR = 2.642; P ＜ 0.001 OR = 2.065) were predictors of both the 30-day and 4-year mortality rates. Renal failure (P = 0.009, OR = 1.643) performed good in prediction of the 4-year mortality. The mortality of fungaemia is high. Age，the serum bilirubin and INR are good predictors of the 30-day and 4-year mortality rates of fungaemia. Renal failure has good performance in predicting the long-term mortality.
Highlights
Fungaemia has high short-term and long-term mortality rates
The increase in incidence is caused by advancement of modern medicine, such as organ transplantation [3, 4], broad-spectrum antimicrobial agents [5] and long-term central venous access devices [6], all of which can prolong the survival time while putting patients at high risk of fungal infections
There are many studies on bacterial and fungal blood stream infections (BSIs) [7, 8], only a few of them focus on predicting the long-term prognosis of fungaemia
Summary
Fungaemia has high short-term and long-term mortality rates. The incidence rate of invasive fungal infection has increased dramatically. The proportion of nosocomial BSIs induced by antibiotic-resistant organisms is increasing in US hospitals [2]. The increase in incidence is caused by advancement of modern medicine, such as organ transplantation [3, 4], broad-spectrum antimicrobial agents [5] and long-term central venous access devices [6], all of which can prolong the survival time while putting patients at high risk of fungal infections. There are many studies on bacterial and fungal BSIs [7, 8], only a few of them focus on predicting the long-term prognosis of fungaemia
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