Table 3. Univariate analysis of factors associated with 30-day mortality in medical and surgical wards.
| VARIABLE | Alive N = 266 (%) | Died N = 103 (%) | p-value |
|---|---|---|---|
| Demographics | |||
| Age, years | 65.1±15.9 | 68.8±17.3 | 0.05 |
| Sex, male | 157 (59) | 63 (61.2) | 0.72 |
| Hospital admission at the time of the candidemia episode | |||
| Medical ward | 127 (47.7) | 77 (74.8) | <0.001 |
| Surgical ward | 139 (52.3) | 26 (25.2) | |
| Comorbidities | |||
| Solid tumor | 115 (43.2) | 53 (51.5) | 0.16 |
| Solid organ transplantation | 12 (4.5) | 3 (2.9) | 0.35 |
| HIV/AIDS | 4 (1.5) | 5 (4.9) | 0.12 |
| Cardiac disease | 88 (33.1) | 40 (38.8) | 0.33 |
| Pulmonary disease | 57 (21.4) | 28 (27.2) | 0.27 |
| Liver disease | 36 (13.5) | 28 (27.5) | 0.003 |
| Renal insufficiency | 64 (24.1) | 35 (34) | 0.06 |
| Diabetes mellitus | 66 (24.8) | 32 (31.1) | 0.23 |
| Neurologic disease | 61 (22.9) | 25 (24.3) | 0.78 |
| Autoimmune disease | 11 (4.1) | 2 (1.9) | 0.59 |
| Previous antifungal treatment | 39 (14.7) | 25 (24.3) | 0.03 |
| Risk factors for candidemia | |||
| Previous antibiotic therapy | 251 (94.4) | 93 (90.3) | 0.17 |
| Previous corticosteroid therapy | 62 (23.3) | 33 (32.0) | 0.11 |
| Immunosuppressive therapy | 53 (19.9) | 28 (27.2) | 0.16 |
| Central venous catheter | 185 (69.5) | 68 (66.0) | 0.53 |
| Surgery (all types <3 months) | 159 (59.8) | 35 (34.0) | <0.001 |
| Abdominal surgery | 97 (36.5) | 20 (19.4) | 0.02 |
| Neutropenia | 1 (0.4) | 5 (4.9) | <0.007 |
| Mucositis at diagnosis | 8 (3.0) | 8 (7.8) | 0.08 |
| TPN during candidemia | 123 (46.2) | 42 (40.8) | 0.35 |
| Source of infection | |||
| Primary | 129 (48.5) | 71 (68.9) | <0.001 |
| Central Venous Catheter | 105 (39.5) | 24 (23.3) | 0.003 |
| Abdomen | 22 (8.3) | 4 (3.9) | 0.17 |
| Urinary tract | 9 (3.4) | 4 (3.9) | 0.76 |
| Pitt score | 1 (0–2) | 2 (1–4) | <0.001 |
| Clinical features | |||
| Sepsis | 230 (86.5) | 68 (66.0) | <0.001 |
| Severe sepsis or septic shock at onset | 36 (13.5) | 35 (34.0) | <0.001 |
| ICU admission | 22 (8.3) | 10 (9.7) | 0.68 |
| Concomitant bacteremia | 38 (14.3) | 22 (21.4) | 0.11 |
| Persistent candidemia | 63 (30.6) | 15 (41.7) | 0.24 |
| Spread to other organs | |||
| Spleen | 3 (1.1) | 0 | 0.56 |
| Eyes | 7 (2.1) | 1 (1) | 0.70 |
| Heart | 5 (1.9) | 2 (1.9) | 1 |
| Other* | 7 (2.6) | 2 (1.9) | 1 |
| Candida species | |||
| C. albicans | 141 (53) | 55 (53.4) | 1 |
| C. parapsilosis | 60 (22.6) | 19 (18.4) | 0.47 |
| C. glabrata | 39 (14.7) | 13 (12.6) | 0.73 |
| C. tropicalis | 24 (9) | 9 (8.7) | 1 |
| C. krusei | 6 (2.3) | 5 (4.9) | 0.18 |
| C. guilliermondii | 3 (1.1) | 2 (1.1) | 0.62 |
| Other | 9 (3.4) | 7 (6.8) | 0.16 |
| Fluconazole-non-susceptible strains | 10/254 (3.9) | 7/93 (7.5) | 0.17 |
| Empirical antifungal therapy (before positive blood culture) | 42 (15.8) | 17 (16.5) | 0.87 |
| Appropriate early antifungal therapy | 175 (65.8) | 48 (46.6) | 0.001 |
| Initial antifungal agents | |||
| Azoles | 172 (64.7) | 45 (43.7) | <0.001 |
| Echinocandins | 56 (21.1) | 21 (20.4) | 1 |
| Liposomal amphotericin B | 7 (2.6) | 2 (1.9) | 1 |
| Combination | 18 (6.8) | 5 (4.9) | 0.63 |
| No antifungal therapy | 13 (4.9) | 30 (29.1) | <0.001 |
| Early CVC removal | 146 (54.9) | 26 (25.5) | <0.001 |
| Appropriate early management of candidemia | 107 (40.2) | 16 (15.5) | <0.001 |
CVC central venous catheter; ICU intensive care unit TPN total parenteral nutrition;
*Other: central nervous system, lungs, and septic thrombophlebitis