Table 4.
Variables associated with mortality at 90 days in the study patients based on Cox proportional hazard analysis
| Variable | Hazard ratio (95% C.I.) | P-value |
|---|---|---|
| Univariable analysis | ||
| Age | 0.98 (0.94 – 1.02) | 0.35 |
| Gender, female | 1.16 (0.39 – 3.40) | 0.78 |
| Type of transplant (compared to the lung) | ||
| Liver | 1.10 (0.12 – 9.65) | 0.95 |
| Heart | 0.89 (0.06 – 14.24) | 0.94 |
| Kidney | 1.36 (0.17 – 10.65) | 0.77 |
| Retransplant | 0,56 (0.07 – 4.29) | 0.58 |
| Rejection | 0.75 (0.24 – 2.33) | 0.62 |
| Cytomegalovirus infection | 0.35 (0.08 – 1.52) | 0.16 |
| Renal failure at baseline | 2.99 (1.12 – 7.98) | 0.028 |
| Infection within 1 year post-transplant | 1.28 (0.46 – 3.53) | 0.63 |
| Duration of symptoms prior to therapy | 0.99 (0.98 – 1.01) | 0.69 |
| Site of infection | ||
| Central nervous system | 2.15 (0.75 – 6.20) | 0.15 |
| Pulmonary | 0.89 (0.33 – 2.36) | 0.81 |
| Skin, soft-tissue, osteoarticular only | 1.08 (0.14 – 8.20) | 0.94 |
| Fungemia | 3.94 (1.48 – 10.51) | 0.006 |
| Disseminated infection | 4.93 (1.11 – 21.69) | 0.035 |
| Abnormal mental status at presentation | 3.11 (1.17 – 8.31) | 0.023 |
| Primary immunosuppressive agent | ||
| Calcineurin-inhibitor agent (compared to non-calcineurin-inhibitor agent use) | 0.21 (0.07 – 0.59) | 0.003 |
| Tacrolimus | 0.15 (0.05 – 0.49) | .001 |
| CsA | 0.45 (0.13 – 1.59) | .21 |
| Antifungal therapy with amphotericin B (compared to fluconazole) | ||
| Localized infection | 1.85 (0.11 – 29.64) | 0.66 |
| Disseminated infection | 1.06 (0.13 – 8.21) | 0.95 |
| 5 flucytosine use as initial therapy (compared to no 5 flucytosine use) | ||
| Localized infection* | -- | -- |
| Disseminated infection | 0.66 (0.22 – 1.97) | 0.46 |
| Multivariable analysis** | ||
| Disseminated infection | 4.13 (0.92 – 18.42) | 0.063 |
| Receipt of a calcineurin-inhibitor agent | 0.21 (0.06 – 0.66) | 0.008 |
| Renal failure | 3.14 (1.06 – 9.26) | 0.037 |
*
Unable to calculate as there were no deaths in this group. Variables included in the model were abnormal mental status, renal failure, disseminated infection, and receipt of calcineurin-inhibitor agent. Using backward selection with factors removed at 0.20, abnormal mental status fell from the model.
**
There were no significant interactions and no significant violation of the proportional hazard assumption.