Table 3. Characteristics of US military patients with laboratory evidence of invasive fungal infection of wound sustained on battlefield, Afghanistan, June 1, 2009–December 31, 2014*.
| Characteristic | IFI, n = 94 | High suspicion, n = 61 | p value† | Low suspicion, n = 91 | p value‡ |
|---|---|---|---|---|---|
| Blast injury | 92 (97.9) | 61 (100) | 0.520 | 89 (97.8) | 1.000 |
| Injured while on foot patrol§ |
73 (94.8) |
51 (94.4) |
1.000 |
80 (95.2) |
1.000 |
| Injury severity score | |||||
| Median (IQR) | 40 (33–50) | 38 (30–45) | 0.262 | 33 (27–42) | <0.001 |
| ≥26/critical |
87 (92.6) |
52 (85.3) |
0.144 |
75 (82.4) |
0.037 |
| Blood units received 24 h after injury, median (IQR)¶ | 31 (21–43) | 21 (15–32) | 0.003 | 17 (12–24) | <0.001 |
| 10–20 | 18 (19.4) | 25 (41.0) | 0.003 | 42 (48.3) | <0.001 |
| >20 |
71 (76.3) |
31 (50.8) |
0.002 |
30 (34.5) |
<0.001 |
| Traumatic amputation# |
64 (68.1) |
48 (78.7) |
0.150 |
73 (80.2) |
0.060 |
| SOFA score, median (IQR) | |||||
| Germany | 11 (7–13) | 8 (4–13) | 0.028 | 6 (2–9) | <0.001 |
| US hospital |
7 (2–11) |
4 (1–8) |
0.022 |
1 (0–6) |
<0.001 |
| Duration of antifungal use, median (IQR) |
24 (14–43) |
21 (14–27) |
0.006 |
0 |
NA |
| Outcome | |||||
| Surgical amputation** | 50 (53.2) | 26 (42.6) | 0.199 | 24 (26.4) | <0.001 |
| Death | 8 (8.5) | 1 (1.6) | 0.090 | 0 | 0.007 |
*Values are no. (%) except as indicated. Patients with >1 wound with differing classifications are classified at the highest level. One patient with a wound classified as high suspicion died within 24 h of collection of sample providing laboratory evidence of fungal infection, precluding classification as having an IFI. IFI, invasive fungal wound infection; IQR, interquartile range; SOFA, sequential organ failure assessment. †Compares characteristics between those having an IFI and those having a high-suspicion wound. ‡Compares characteristics between those having an IFI and those having a low-suspicion wound. §Information about whether patient was on foot patrol or in a vehicle is missing for 17 IFI patients, 7 patients with high-suspicion wounds, and 7 patients with low-suspicion wounds. Percentages and p-values based on total minus missing. ¶Information missing for 1 patient with an IFI and 4 patients with low-suspicion wounds. Percentages and p-values based on total minus missing. #Includes amputations that occurred before admission to a US hospital. **Defined as amputation that occurred after admission to a US hospital.