Table 4. Variables associated with 30-day mortality after cryptococcosis in 60 renal transplant recipients.
| Univariate analysis | Multivariate analysis | |||||
|---|---|---|---|---|---|---|
| Survival, % | Death, % | |||||
| Variables (N°. patients) n = 60 | n = 37 | n = 23 | P-value | OR | 95% CI | P-value |
| Age, mean, ±SD, years (60) | 48.1 ± 12.51 | 49.6 ± 12.94 | 0.657 | |||
| Male (38) | 56.8 | 73.9 | 0.180 | |||
| Induction immunosuppressive therapy (24) | 27 | 60.9 | 0.009 | |||
| Deceased donor (36) | 48.6 | 78.2 | 0.023 | |||
| Prior rejection (24) | 43.2 | 34.8 | 0.515 | |||
| Cytomegalovirus infectiona (7) | 13.5 | 8.7 | 0.697 | |||
| Receipt of a calcineurin-inhibitor agentb (45) | 64.9 | 91.3 | 0.021 | |||
| Receipt of a tacrolimusb (34) | 45.9 | 73.9 | 0.034 | |||
| Duration of symptoms before diagnosis, mean, ±SD (56) | 35.4 ± 42.69 | 29.2 ± 78.74 | 0.705 | |||
| Time to diagnose after admission, mean, ±SD (57) | 4.7 ± 9.09 | 3.6 ± 4.65 | 0.585 | |||
| Sites of involvement | ||||||
| CNSc (50) | 89.2 | 89.5 | 1 | |||
| Pulmonaryd (30) | 40.5 | 68.2 | 0.04 | |||
| Skin or soft-tissue (12) | 24.3 | 13 | 0.34 | |||
| Disseminated infection (38) | 54.1 | 78.3 | 0.059 | |||
| Fungemia (23) | 18.9 | 69.6 | <0.001 | 3.79 | 1.03–13.91 | 0.044 |
| C. gattii infection (6) | 5.4 | 17.4 | 0.191 | |||
| Non-VNI genotype (20) | 32.4 | 34.5 | 0.851 | |||
| Creatinine at admission ≥2 mg dL−1 (34) | 51.4 | 65.2 | 0.292 | |||
| Somnolence at admissione (19) | 27.3 | 58.8 | 0.029 | |||
| Confusion at admissione (19) | 30.3 | 52.9 | 0.118 | |||
| Headache at admissione(30) | 72.7 | 35.3 | 0.01 | 0.13 | 0.04–0.42 | 0.001 |
| Intracranial hypertensionf (16) | 48.1 | 33.3 | 0.7 | |||
| Respiratory failureb,g (7) | 6.7 | 40 | 0.08 | |||
| CSF cell countb, mean, ±SD, mm3 (42) | 138.5 ± 250.04 | 101.1 ± 92.8 | 0.664 | |||
| CSF glucose ratiob, mean, ±SD, mg dL−1 (41) | 47.3 ± 24.63 | 39.2 ± 31.89 | 0.420 | |||
| Positive CSF India inkh (23) | 42.4 | 64.3 | 0.170 | |||
| CSF antigen titre >1:512i (24) | 43.3 | 84.6 | 0.012 | |||
| Positive pulmonary culturej (9) | 33.3 | 100 | 0.021 | |||
| AMBd as primary therapyk (53) | 97.3 | 100 | 1 | |||
| Combination therapyk (16) | 24.3 | 41.2 | 0.208 | |||
| Change in immunosuppressive regime after infectionc (44) | 80.6 | 75 | 0.737 | |||
| Discontinuation of tacrolimus after infectionl (24) | 41.4 | 80 | 0.025 | |||
| Graft loss within 30 daysm (7) | 13.5 | 100 | 0.028 | |||
| Fluconazole MIC ≥ 16 mg l−1 (8) | 25 | 75 | 0.045 | |||
Note: OR, odds ratio; CI, confidence interval; SD, standard deviation; CNS, central nervous system; CSF, cerebrospinal fluid; AMBd, amphotericin B deoxycholate; MIC, minimum inhibitory concentration.
aInfection occurring within 6 months of the onset of cryptococcosis.
bAt cryptococcosis diagnosis.
cData was available for 56 patients.
dData was available for 59 patients.
eData was available for 50 patients.
fData was available for 36 patients.
gData was available for 30 patients.
hData was available for 47 patients.
iData was available for 43 patients.
jData was available for 13 patients.
kData was available for 54 patients, at least 2 consecutive days of the same antifungal therapy.
lData was available for 44 patients.
mData was available for 39 patients.