Delay in the initiation of appropriate antifungal therapy is associated with substantial morbidity and mortality. The aim of this study was to derive a risk score system for the development of invasive fungal infections in an intensive care unit (ICU). We retrospectively evaluated 1812 patients who stayed in the ICU for > or = 4 days, used univariate and multivariable logistic regression to identify potential risk factors associated with invasive fungal infections (IFI), and created a risk score system. ⋯ The percentages of patients with ICU-IFI in the low, intermediate, and high risk groups were 5.2%, 31.6%, and 63.2% in the derivation cohort and 4.2%, 30.1%, and 66.7% in the validation cohort, respectively. A new risk score was developed to predict ICU-IFI and was validated in an independent cohort. The new risk score may help clinicians identify patients who are at high risk of developing ICU-IFI and increase their odds of survival.
Yun Liao, Ming-Kang Zhong, Hong-Bin Xu, and Ling Li.
Department of Pharmacy, Huashan Hospital, Fudan University, Shanghai, China.
Pharmazie. 2013 Jun 1;68(6):459-64.
AbstractDelay in the initiation of appropriate antifungal therapy is associated with substantial morbidity and mortality. The aim of this study was to derive a risk score system for the development of invasive fungal infections in an intensive care unit (ICU). We retrospectively evaluated 1812 patients who stayed in the ICU for > or = 4 days, used univariate and multivariable logistic regression to identify potential risk factors associated with invasive fungal infections (IFI), and created a risk score system. Seven variables were identified as important predictors of ICU-IFI (diabetes mellitus, gastrointestinal surgery, hematological malignancies, mechanical ventilation > or = 2 days, central venous catheter, total parenteral nutrition, broad-spectrum antibiotic use > or = 4 days). The area under the receiver operating characteristic curve was 0.807 and was similar in the validation set. The percentages of patients with ICU-IFI in the low, intermediate, and high risk groups were 5.2%, 31.6%, and 63.2% in the derivation cohort and 4.2%, 30.1%, and 66.7% in the validation cohort, respectively. A new risk score was developed to predict ICU-IFI and was validated in an independent cohort. The new risk score may help clinicians identify patients who are at high risk of developing ICU-IFI and increase their odds of survival.