title: [Risk factors and prognosis of invasive fungal infections in patients with hematological diseases].
abstract: OBJECTIVE
  To investigate the incidence, risk factors, prognosis and high risk patients of invasive fungal infections (IFI) in patients with hematological diseases.
  
  
  METHODS
  : Over 2-week hospitalized patients from January 2007 to December 2008 were retrospectively reviewed. Logistic regression was used to analyze the risk factors of IFI, and recursive partitioning to reveal high risk patients. Incidence of IFI was estimated by cumulative incidence function, and the prognosis by Kaplan-Meier method.
  
  
  RESULTS
  A total of 1048 assessable treatment cycles were recorded and 93 cases of IFI were diagnosed, with an incidence of 8.87 per 100 treatment cycles. Multivariate logistic regression revealed the following risk factors: age (OR 1.025, 95% CI 1.010-1.041, P = 0.002), duration of neutropenia (OR 1.028, 95% CI 1.014-1.042, P < 0.0001) and uncontrolled underlying diseases (OR 2.620, 95% CI 1.608-4.268, P = 0.0001). Recursive partitioning found two groups of high risk patients: (1) patients with uncontrolled underlying diseases and neutropenia duration > or = 58 days (7/12, 58.3%), (2) patients with uncontrolled underlying diseases and age > or = 33 years (40/208, 19.2%). At the end of follow-up, 111 cases of IFI were recorded in 451 patients, with a 1-year cumulative incidence of 27.1%. In patients with established IFI, overall survival rate and IFI related mortality rate at 12 weeks after diagnosis were 83.4% and 13.5% respectively.
  
  
  CONCLUSIONS
  Age, duration of neutropenia and uncontrolled underlying diseases are risk factors of IFI; patients with uncontrolled underlying diseases and age > or = 33 years were at high risk of IFI and need major concern. IFI has a better prognosis and a lower related mortality in this study.
authors.affiliation: Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, Tianjin 300020, China.
authors.forename: A-Xia
authors.initials: AX
authors.lastname: Song
authors.forename: Yong
authors.initials: Y
authors.lastname: Huang
authors.forename: Dong-Lin
authors.initials: DL
authors.lastname: Yang
authors.forename: Jia-Lin
authors.initials: JL
authors.lastname: Wei
authors.forename: Zhang-Song
authors.initials: ZS
authors.lastname: Yan
authors.forename: Mei
authors.initials: M
authors.lastname: Wang
authors.forename: Er-Lie
authors.initials: EL
authors.lastname: Jiang
authors.forename: Ai-Ming
authors.initials: AM
authors.lastname: Pang
authors.forename: Qiao-Ling
authors.initials: QL
authors.lastname: Ma
authors.forename: Wei-Hua
authors.initials: WH
authors.lastname: Zhai
authors.forename: Rong-Li
authors.initials: RL
authors.lastname: Zhang
authors.forename: Si-Zhou
authors.initials: SZ
authors.lastname: Feng
authors.forename: Ming-Zhe
authors.initials: MZ
authors.lastname: Han
mesh_terms: D005260:Female; D006402:Hematologic Diseases / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009181:Mycoses / Q000453:epidemiology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors