10, kandidemi sırasında santral venöz kateter varlığı, kandidemi geliştikten sonra santral venöz kateterin çekilmemesi, total parenteral nütrisyon, etkenin Candida albicans olması ve antifungal tedaviye başlanamaması mortalite risk faktörleri olarak bulundu. Çok değişkenli analizde, yaş > 65, YBÜ'de yatma, kandidemi atağı sırasında sepsis varlığı, etkenin C. albicans olması ve antifungal tedaviye başlanamaması mortaliteyi etkileyen bağımsız risk faktörleri olarak tespit edildi. Sonuç: Bu çalışma, YBÜ'de yatan yüksek riskli hastalarda, geniş spektrumlu antibiyotik tedavisine rağmen düşmeyen ateş varlığında ampirik antifungal tedavi başlanmasının ve varsa santral venöz kateterin çekilmesiyle kandidemi ile ilişkili mortalite oranının düşürülebileceğini göstermektedir. Introduction: Candidemia is a serious infection with a high mortality rate. Patients and Methods: This prospective case-control study was conducted between January 2004 and December 2007. Hospitalized patients who had Candida spp. in their blood cultures were followed until death or discharge. Mortality was considered to be related to candidemia if the patient was receiving antifungal treatment for candidemia when death occurred or if they died before initiation of antifungal agent, if no other cause of death was detected. Variables of the patients with candidemia-related death and the patients who survived after a candidemia episode were compared statistically for the detection of candidemia-related mortality risk factors. Results: A total of 124 patients were included in the study. The overall candidemia-related mortality was 66.1%. Univariate predictors associated with mortality were age > 65 years, hospitalization in the intensive care unit (ICU), sepsis syndrome during the candidemia episode, Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) II score > 10, presence of central venous catheter during candidemia, central venous catheter not removed after development of candidemia, total parenteral nutrition, Candida albicans etiology, and lack of antifungal therapy. In the multivariate analysis, age 65 years, hospitalization in ICU, sepsis syndrome during the candidemia episode, C. albicans etiology, and lack of antifungal therapy were independent factors adversely influencing outcome. Conclusion: This study suggested that candidemia-related mortality can be reduced by starting empirical antifungal treatment in the high-risk ICU patients with refractory fever, especially for those under broad-spectrum antibiotics, and by removing the central venous catheter as a part of the treatment.">
[PDF] Risk factors for mortality in pastients with candidemi: A prospective case-control study | [PDF] Kandidemi gelişen hastalarda mortalite risk faktörleri: Prospektif olgu-kontrollü çalışma
10, kandidemi sırasında santral venöz kateter varlığı, kandidemi geliştikten sonra santral venöz kateterin çekilmemesi, total parenteral nütrisyon, etkenin Candida albicans olması ve antifungal tedaviye başlanamaması mortalite risk faktörleri olarak bulundu. Çok değişkenli analizde, yaş > 65, YBÜ'de yatma, kandidemi atağı sırasında sepsis varlığı, etkenin C. albicans olması ve antifungal tedaviye başlanamaması mortaliteyi etkileyen bağımsız risk faktörleri olarak tespit edildi. Sonuç: Bu çalışma, YBÜ'de yatan yüksek riskli hastalarda, geniş spektrumlu antibiyotik tedavisine rağmen düşmeyen ateş varlığında ampirik antifungal tedavi başlanmasının ve varsa santral venöz kateterin çekilmesiyle kandidemi ile ilişkili mortalite oranının düşürülebileceğini göstermektedir.">
10, kandidemi sırasında santral venöz kateter varlığı, kandidemi geliştikten sonra santral venöz kateterin çekilmemesi, total parenteral nütrisyon, etkenin Candida albicans olması ve antifungal tedaviye başlanamaması mortalite risk faktörleri olarak bulundu. Çok değişkenli analizde, yaş > 65, YBÜ'de yatma, kandidemi atağı sırasında sepsis varlığı, etkenin C. albicans olması ve antifungal tedaviye başlanamaması mortaliteyi etkileyen bağımsız risk faktörleri olarak tespit edildi. Sonuç: Bu çalışma, YBÜ'de yatan yüksek riskli hastalarda, geniş spektrumlu antibiyotik tedavisine rağmen düşmeyen ateş varlığında ampirik antifungal tedavi başlanmasının ve varsa santral venöz kateterin çekilmesiyle kandidemi ile ilişkili mortalite oranının düşürülebileceğini göstermektedir. Introduction: Candidemia is a serious infection with a high mortality rate. Patients and Methods: This prospective case-control study was conducted between January 2004 and December 2007. Hospitalized patients who had Candida spp. in their blood cultures were followed until death or discharge. Mortality was considered to be related to candidemia if the patient was receiving antifungal treatment for candidemia when death occurred or if they died before initiation of antifungal agent, if no other cause of death was detected. Variables of the patients with candidemia-related death and the patients who survived after a candidemia episode were compared statistically for the detection of candidemia-related mortality risk factors. Results: A total of 124 patients were included in the study. The overall candidemia-related mortality was 66.1%. Univariate predictors associated with mortality were age > 65 years, hospitalization in the intensive care unit (ICU), sepsis syndrome during the candidemia episode, Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) II score > 10, presence of central venous catheter during candidemia, central venous catheter not removed after development of candidemia, total parenteral nutrition, Candida albicans etiology, and lack of antifungal therapy. In the multivariate analysis, age 65 years, hospitalization in ICU, sepsis syndrome during the candidemia episode, C. albicans etiology, and lack of antifungal therapy were independent factors adversely influencing outcome. Conclusion: This study suggested that candidemia-related mortality can be reduced by starting empirical antifungal treatment in the high-risk ICU patients with refractory fever, especially for those under broad-spectrum antibiotics, and by removing the central venous catheter as a part of the treatment.">
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