MORTALITY AND ITS RISK FACTORS AMONG IN-PATIENTS WITH INVASIVE ASPERGILLOSIS TREATED WITH VORICONAZOLE

Abstract

Invasive aspergillosis (IA), a cause of mortality in immunocompromised patients, is treated in Thailand with voriconazole. We aimed to determine the overall and 90-day mortality rates among IA in-patients treated with voriconazole and the factors significantly associated with mortality in order to guide empiric treatment of IA at Rajavithi Hospital, Bangkok, Thailand. We retrospectively reviewed the charts of all in-patients treated at the study hospital for IA with voriconazole during 2015-2020. We evaluated selected factors to determine significant associations with mortality. A total of 33 subjects were included in our study; 55% female (n = 18), of which 9 patients (27%) died. The number of study subjects was far fewer than the minimum number of subjects calculated to be needed for statistical significance in our study. On univariate analysis male sex (p = 0.01) and acute renal failure (p = 0.095) were significantly (p<0.1) associated with mortality. On multivariate analysis, male sex (p = 0.013) was the only factor significantly (p<0.05) associated with mortality. It should be noted that these results may not reflect actual significance due to the overall number of study subjects not reaching the minimum calculated number. In summary, the mortality rate among study subjects was high, especially among males. We conclude there is a need to identify methods to reduce mortality among patients with IA at the study institution. Further studies are need to determine what methods can reduce mortality in this study population, such as changing the current treatment regimen with voriconazole.