PB2032 BASELINE PREDICTORS INFLUENCING THE PROGNOSIS OF INVASIVE ASPERGILLOSIS IN ADULTS

Abstract

Please indicate where the abstract has been published before: Journal of Infection.Background:Invasive aspergillosis (IA) is a serious hazard to hematological and critical care patients.Aims:To understand prognostic variables we analyzed original articles identifying baseline factors that predict treatment outcome in patients with IA.Methods: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.Results:In total, 58 studies from 267 centers reported 7,320 patients with IA, and 40 different predictors. Unfavorable 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‐versus‐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).Summary/Conclusion:At diagnosis of IA, most frequently identified predictors of outcome were neutropenia, corticosteroid use, elevated galactomannan, renal failure, and disseminated disease.