1. A multi‐institutional review of outcomes in biopsy‐proven chronic invasive fungal sinusitis.
- Author
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Humphreys, Ian M., Wandell, Grace M., Miller, Craig, Rathor, Aakanksha, Schmidt, Rodney A., Turner, Justin H., Hwang, Peter H., and Davis, Greg E.
- Subjects
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SINUSITIS , *UNIVARIATE analysis , *SURVIVAL analysis (Biometry) , *HEMATOLOGIC malignancies , *PARANASAL sinus diseases - Abstract
Background: Chronic invasive fungal sinusitis (CIFS) is a rare, life‐threatening infection of the nose and sinuses. This study aims to identify factors that impact survival in 1 of the largest cohorts to date. Methods: Pathology records were reviewed for biopsy‐proven CIFS from 3 tertiary academic institutions from 1995 to 2016. Variables were analyzed using log‐rank survival analysis. Univariate Cox regression was performed at 1 and 12 months. Results: Thirty‐eight patients were included. Hematologic malignancy and diabetes were the most common underlying diseases (32% each). Aspergillus was the most common fungus (63%). Greater than 75% of the patients had an absolute neutrophil count (ANC) >1000 at the time of diagnosis. Overall survival at 1, 6, and 12 months was 89%, 68%, and 48%, respectively. In univariate analysis, factors associated with worse survival included: ANC <500 at 12 months (hazard ratio [HR] 4.8; p = 0.01), ANC <1000 at 12 months (HR 5.8; p = 0.001), and recent chemotherapy (HR 4; p = 0.01). The following factor was associated with improved survival in univariate analysis: ANC as a linear variable in the entire cohort (HR 0.7; p = 0.005). Conclusion: We present a multi‐institutional case‐series of CIFS and long‐term follow‐up. ANC <1000 at time of diagnosis and recent chemotherapy (within 1 month of diagnosis) are associated with poorer survival, whereas a rising ANC >1000 is associated with improved survival at 12 months. Further prospective studies are needed to further define factors that affect outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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