A score for predicting invasive pulmonary aspergillosis in immunocompetent critically ill patients.

Abstract

BACKGROUND:

Delayed treatment leads to increased mortality in critically ill patients with invasive pulmonary aspergillosis (IPA). We aimed to develop and validate a prediction score based on novel biomarkers and clinical risk factors to identify IPA in immunocompetent patients in the intensive care unit (ICU).

METHODS:

A retrospective study was conducted to collect medical information and novel biomarkers upon ICU admission. Risk factors adopted for the final prediction score were identified using multivariate logistic regression analysis.

RESULTS:

We retrospectively collected 1841 critical ill patients between January 2018 and August 2022. Patients with IPA had higher C-reactive protein-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio, systemic immune-inflammation index and lower prognostic nutritional index (PNI). Chronic obstructive pulmonary disease (COPD), continuous renal replacement therapy (CRRT), high dose of corticosteroids, broad-spectrum antibiotics, blood galactomannan (GM) positivity and high CAR were independent risk factors for IPA and were entered into the final prediction score. The score had good discrimination, with the area under receiver operating characteristic curve of 0.816 and 0.780 for the training and validation cohorts, respectively, and good calibration.

CONCLUSION:

A score based on six clinical and novel immunological biomarkers showed promising predictive value for antifungal treatment in immunocompetent ICU patients.

• Authors: Wen Li, Gang Chen, Fengyu Lin, Hang Yang, Yanhui Cui, Rongli Lu, Chao Song, Haitao Li, Yi Li, Pinhua Pan
• Journal: European journal of clinical investigation (Eur J Clin Invest) Vol. 53 Issue 7 Pg. e13985 (Jul 2023) ISSN: 1365-2362 [Electronic] England
• PMID: 36920323 (Publication Type: Journal Article)
• Copyright: © 2023 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

Chemical References

• Biomarkers

Topics

• Humans
• Biomarkers
• Critical Illness
• Immunocompromised Host
• Intensive Care Units
• Invasive Pulmonary Aspergillosis (diagnosis)
• Predictive Value of Tests
• Reproducibility of Results
• Retrospective Studies
• Risk Factors
• Male
• Female
• Middle Aged
• Aged