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
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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