Table 3.
Risk factors for death in candidemic patients, according ICU vs non-ICU setting
| Characteristics | Whole population | Intensive care | Non-intensive care | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Death (n = 46) | Survival (n = 146) | p | Death (n = 32) | Survival (n = 51) | p | Death (n = 14) | Survival (n = 95) | p | |
| Age | 70 (55–74) | 62 (53–73) | 0.10 | 66 (53–73) | 59 (52–70) | 0.14 | 73 (68–76) | 64 (53–74) | 0.12 |
| Underlying medical conditions | |||||||||
| Heart disease | 42 (91%) | 117 (80%) | 0.09 | 30 (94%) | 46 (90%) | 0.57 | 12 (86%) | 71 (75%) | 0.40 |
| Respiratory disease | 11 (24%) | 20 (14%) | 0.10 | 9 (28%) | 11 (22%) | 0.50 | 2 (14%) | 9 (9%) | 0.60 |
| Renal failure | 32 (70%) | 42 (29%) | < 0.001 | 25 (78%) | 26 (51%) | 0.02 | 7 (50%) | 16 (17%) | 0.008 |
| Liver disease | 7 (15%) | 12 (9%) | 0.20 | 6 (19%) | 6 (12%) | 0.38 | 1 (7%) | 7 (7%) | 1.00 |
| Central nervous system disease | 11 (24%) | 19 (13%) | 0.08 | 8 (25%) | 6 (12%) | 0.12 | 3 (21%) | 13 (14%) | 0.40 |
| Diabetes | 15 (34%) | 34 (23%) | 0.20 | 11 (34%) | 12 (24%) | 0.28 | 4 (29%) | 22 (23%) | 0.70 |
| Solid organ transplant | 4 (9%) | 5 (3%) | 0.15 | 4 (13%) | 2 (4%) | 0.16 | 0 (0%) | 3 (3%) | – |
| Solid cancer | 9 (20%) | 32 (22%) | 0.70 | 5 (16%) | 12 (24%) | 0.39 | 5 (36%) | 23 (24%) | 0.40 |
| Onco-hematological disease | 1 (2%) | 9 (6%) | 0.30 | 0 (0%) | 1 (2%) | – | 1 (7%) | 8 (8%) | 0.90 |
| Neutropenia | 2 (4%) | 9 (6%) | 0.60 | 0 (0%) | 0 (0%) | – | 2 (14%) | (9%) | 0.60 |
| Inflammatory disease | 6 (13%) | 15 (10%) | 0.60 | 3 (9%) | 4 (8%) | 0.81 | 3 (21%) | 11 (12%) | 0.30 |
| Immunosuppression | 4 (9%) | 6 (4%) | 0.20 | 3 (9%) | 2 (4%) | 0.32 | 1 (7%) | 4 (4%) | 0.60 |
| Pancreatitis | 2 (4%) | 9 (6%) | 0.60 | 0 (0%) | 3 (6%) | – | 2 (14%) | 6 (6%) | 0.30 |
| Bacterial co-infection | 41 (89%) | 99(68%) | 0.007 | 30 (94%) | 40 (78%) | 0.08 | 11 (79%) | 59 (62%) | 0.20 |
| Septic shock concomitant to candidemia | 27 (59%) | 28 (19%) | < 0.001 | 18 (56%) | 13 (25%) | 0.008 | 9 (64%) | 15 (16%) | < 0.001 |
| SAPS2 | NA | NA | NA | 62 (43–75) | 48 (40–66) | 0.14 | NA | NA | NA |
| Hospital management and clinical risk factors | |||||||||
| Intensive care Unit | 35 (76%) | 62 (42%) | < 0.001 | NA | NA | NA | NA | NA | NA |
| Extra renal epuration | 24 (52%) | 20 (14%) | < 0.001 | 20 (63%) | 16 (31%) | 0.006 | 4 (29%) | 4 (4%) | 0.005 |
| Invasive mechanical ventilation | 31 (67%) | 44 (30%) | < 0.001 | 29 (91%) | 40 (78%) | 0.16 | 2 (14%) | 4 (4%) | 0.15 |
| Central venous catheter | 42 (91%) | 128 (88%) | 0.60 | 31 (97%) | 49 (96%) | 0.85 | 11 (79%) | 79 (84%) | 0.60 |
| CVC ablation | 33 (72%) | 108 (74%) | 0.80 | 25 (78%) | 44 (86%) | 0.34 | 8 (57%) | 64 (67%) | 0.50 |
| Delay between the first day of candidemia and CVC ablation | 2 (0–5) | 2 (1–4) | 0.60 | 2 (0–3) | 2 (1–4) | 0.34 | 5 (2–6) | 2 (1–3) | 1.00 |
| Total parenteral nutrition | 21 (46%) | 56 (39%) | 0.40 | 15 (47%) | 23 (45%) | 0.87 | 6 (43%) | 33 (35%) | 0.60 |
| Antiacids | 38 (83%) | 118 (81%) | 0.80 | 27 (84%) | 41 (80%) | 0.65 | 11 (79%) | 77 (81%) | 0.80 |
| Urinary catheter | 40 (87%) | 97 (67%) | 0.01 | 30 (94%) | 47 (92%) | 1.00 | 11 (71%) | 50 (53%) | 0.20 |
| Surgery before candidemia | 18 (39%) | 71 (49%) | 0.30 | 14 (44%) | 31 (61%) | 0.22 | 4 (29%) | 40 (42%) | 0.30 |
| Antifungal prophylaxis | 6 (13%) | 14 (10%) | 0.50 | 5 (16%) | 3 (6%) | 0.16 | 1 (7%) | 11 (12%) | 0.60 |
| Delay of introduction of antifungal therapy | 1 (0–2) | 2 (0–2) | 0.50 | 1 (−1–2) | 2 (0–3) | 0.04 | 2 (1–2) | 2 (0–2) | 0.60 |
| Antibiotics | 44 (96%) | 130 (89%) | 0.20 | 31 (97%) | 48 (94%) | 0.57 | 13 (93%) | 82 (86%) | 0.50 |
| Number of antibiotics | 4 (2–5) | 2 (1–3) | < 0.001 | 4 (3–5) | 3 (2–4) | 0.04 | 2 (1–3) | 2 (1–3) | 0.14 |
| Laboratory data | |||||||||
| Leucocytes (.103 /mm3) | 18 (10–29) | 13 (8–20) | 0.009 | 21 (12–31) | 19 (13–26) | 0.61 | 12 (7–28) | 10 (7–17) | 0.11 |
| CRP (mg/L) | 208 (108–305) | 152 (87–246) | 0.04 | 167 (80–306) | 186 (113–244) | 0.59 | 212 (145–282) | 141 (69–247) | 0.03 |
| PCT (μg/L) | 9 (2–40) | 3 (1–9) | 0.20 | 8 (2–19) | 3 (1–11) | 0.18 | 48 (43–52) | 2 (0–6) | 0.30 |
| Β-D-glucan (pg/mL) | 249 (126–1056) | 85 (20–277) | 0.40 | 251 (140–1065) | 52 (14–236) | 0.47 | 190 (69–2127) | 111 47–451) | 0.60 |
| Candida species in blood cultures | |||||||||
| C. albicans | 30 (65%) | 84 (58%) | 20 (63%) | 33 (65%) | 10 (71%) | 51 (54%) | |||
| C. glabrata | 5 (11%) | 26 (18%) | 0.20 | 3 (9%) | 9 (18%) | 0.41 | 2 (14%) | 17 (18%) | 0.60 |
| C. parapsilosis | 1 (2%) | 18 (12%) | 0.08 | 1 (3%) | 3 (6%) | 0.62 | 0 | 15 (16%) | – |
| C. tropicalis | 1 (2%) | 5 (3%) | 0.60 | 1 (3%) | 3 (6%) | 0.62 | 0 | 2 (2%) | – |
| C. krusei | 3 (7%) | 3 (2%) | 0.20 | 3 (9%) | 0 (0%) | – | 0 | 3 (3%) | – |
NA not applicable