Risk Factors for Death Among Cancer Patients with Fungemia

• Published in: Clinical infectious diseases Vol. 27; no. 1; pp. 107 - 111
• Main Authors: Nucci, Marcio, Silveira, Maria Isabel, Spector, Nelson, Silveira, Fernanda, Velasco, Eduardo, Akiti, Tiyomi, Barreiros, Gloria, Derossi, Andrea, Colombo, Arnaldo L., Pulcheri, Wolmar
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.07.1998; University of Chicago Press
• Subjects: Adult; Aged; Antifungals; Biological and medical sciences; Cancer; Candidemia; Catheters; Clinical Articles; Female; Fungal infections; Fungemia; Fungemia - complications; Fungemia - mortality; Human mycoses; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Mortality; Multivariate Analysis; Mycoses; Mycotic sepsis; Neoplasms - complications; Neoplasms - mortality; Neutropenia; Predisposing factors; Prognosis; Risk Factors; Statistics, Nonparametric; Survival Analysis; Tropical medicine; Tumors; South America; Brazil; America; Infection; Human; Fungemia; Leukopenia; Mycosis; Risk factor; Complication; Hemopathy; Malignant tumor; Multivariate analysis; Age; Neutropenia
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/514609

In order to identify prognostic factors for death among cancer patients with fungemia, an 18-month survey of fungemia in patients with cancer was undertaken in three hospitals in Rio de Janeiro. For the assessment of risk factors for death, the following variables were analyzed: age; gender; underlying cancer; last treatment for the underlying disease; previous surgery; use of antibiotics, antifungal agents, steroids, or total parenteral nutrition; use of a central venous catheter; chemotherapy; radiotherapy; presence and duration of neutropenia; etiologic agent of the fungemia; treatment of the fungemia; clinical manifestations; and performance status (Karnofsky score) on the day of the positive blood culture. In multivariate analysis, the variables associated with an increased risk for death were older age, persistent neutropenia, and low performance status. Identifying risk factors for death may help to define a group of high-risk patients for whom new therapeutic options should be tried.