Clinical manifestations, associated risk factors and treatment outcomes of Chronic Pulmonary Aspergillosis (CPA): Experiences from a tertiary care hospital in Lahore, Pakistan
Autor: | Waqas Akram, Muhammad Bilal Ejaz, Syed Azhar Syed Sulaiman, Amer Hayat Khan, Tauqeer Hussain Mallhi |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Male
Bacterial Diseases Disease Biochemistry law.invention Tertiary Care Centers Hematologic Cancers and Related Disorders Medical Conditions Endocrinology law Risk Factors Medicine and Health Sciences Pakistan Prospective cohort study Multidisciplinary Chronic pulmonary aspergillosis Mortality rate Fungal Diseases Eukaryota Hematology Middle Aged C-Reactive Proteins Intensive care unit Hospitals Intensive Care Units Treatment Outcome Infectious Diseases Aspergillus Oncology Fungal Molds Medicine Female Aspergilloma Research Article Adult medicine.medical_specialty Death Rates Endocrine Disorders Science Population Metrics Internal medicine medicine Diabetes Mellitus Humans Tuberculosis Aspergillosis Risk factor Retrospective Studies Population Biology business.industry Organisms Fungi Biology and Life Sciences Cancers and Neoplasms Proteins medicine.disease Tropical Diseases Health Care Health Care Facilities Metabolic Disorders Pulmonary Aspergillosis business Kidney disease |
Zdroj: | PLoS ONE PLoS ONE, Vol 16, Iss 11 (2021) PLoS ONE, Vol 16, Iss 11, p e0259766 (2021) |
ISSN: | 1932-6203 |
Popis: | Background Chronic pulmonary aspergillosis (CPA) has a wide spectrum of illnesses depending on the progression of the disease and comorbid conditions. However, there is an inadequacy of investigations regarding clinical, laboratory, risk factor and prognostic data on CPA. The current study is aimed to consider the clinical manifestations, risk factors and outcomes of CPA. Methodology Retrospective records of all patients with a confirmed diagnosis of CPA who sought treatment at Gulab Devi Chest Hospital Lahore, Pakistan from January 2017 to December 2019 were evaluated. Data regarding demographics, clinical manifestations, comorbidities, radiographic and microbiological findings, length of hospital stay (LOS) and intensive care unit (ICU) admission was collected and analyzed to identify the factors associated with mortality. The independent factors associated with mortality were also identified by appropriate analyses. Results A total of 218 CPA patients were included in this study. The mean age was 45.75 ± 6.26 years. Of these, 160 (73.4%) were male, and 65 (29.8%) had diabetes. The mean LOS was 18.5 ± 10.9 days. The most common type of CPA was simple aspergilloma (56%) followed by chronic cavitary pulmonary aspergillosis (CCPA) (31.2%). About one half of the patients had a history of pulmonary tuberculosis (TB) and treatment response rates were low in patients with active TB. The overall mortality rate was 27.1%. ICU admission was required for 78 (35.8%) patients. Diabetes mellitus (DM), hematological malignancies and chronic kidney disease (CKD) were the common underlying conditions predicting a poor outcome. Mean LOS, hematological malignancies, consolidation and ICU admission were identified as the independent factors leading to mortality. Conclusions CPA had a significant association with TB in the majority of cases. Treatment response rates in cases with active TB were comparatively low. Cases with high mean LOS, hematological malignancies, consolidation, ICU admission, CKD and DM experienced poor outcomes. High mean LOS, hematological malignancies, consolidation and ICU stay were identified as independent risk factors for mortality. Future large prospective studies, involving aspergillus specific immunoglobulin G (IgG) antibody testing, are required for a better understanding of CPA in Pakistan. |
Databáze: | OpenAIRE |
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