1. Follow-up of Surgical and Nonsurgical Patients With Pulmonary Aspergillosis: A Real-World Study
- Author
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Chen Z, Shang Y, Wasti B, Ou Y, Gong S, Xiang X, and Ouyang R
- Subjects
pulmonary aspergillosis ,antifungal treatment ,surgery ,treatment failure ,prognosis ,Infectious and parasitic diseases ,RC109-216 - Abstract
Zhifeng Chen,1– 4,* Yulin Shang,5,* Binaya Wasti,6 Yanru Ou,1– 4 Subo Gong,7 Xudong Xiang,8 Ruoyun Ouyang1– 4 1Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 2Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 3Clinical Medical Research Center for Pulmonary and Critical Care Medicine in Hunan Province, Changsha, Hunan, 410011, People’s Republic of China; 4Diagnosis and Treatment Center of Respiratory Disease in Hunan Province, Changsha, Hunan, 410011, People’s Republic of China; 5Ophthalmology and Otorhinolaryngology, Zigui Country Hospital of Traditional Chinese Medicine, Yichang, Hubei, 443600, People’s Republic of China; 6B & C Medical College, Teaching Hospital and Research Center, Birtamode, 57204, Nepal; 7Department of Geriatrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 8Department of Emergency, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ruoyun Ouyang, Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha, Hunan, 410011, People’s Republic of China, Email ouyangruoyun@csu.edu.cnObjective: In the real clinical world, both surgery and medication are used to treat pulmonary aspergillosis (PA), but the prognosis of different treatments is unclear. The purpose of this study was to investigate the diagnosis and treatment, follow-up results and prognostic factors of PA patients in the real world, so as to deepen our understanding of PA and improve the prognosis of PA patients.Materials and Methods: Eligible patients with pathologically diagnosed PA (n = 125) were retrospectively enrolled and followed up. Further comparisons and subgroup analyses were performed between patients receiving surgical and nonsurgical treatments. Univariate and multivariate logistic regression analyses were used to investigate the factors associated with treatment failure.Results: A total of 125 patients with PA were included in the study. Of these, 49 (39.2%) received surgical treatment (25 of whom also received postoperative antifungal therapy), while 76 (60.8%) received antifungal therapy alone. The median age was 59 years (46.5– 67 years). Compared with the nonsurgical group, the surgical group had lower inflammatory cell counts and less inflammatory response, and higher hemoglobin and albumin levels. Multivariate logistic regression analysis showed that white blood cell (WBC) levels > 9.5× 109/L and C-reactive protein (CRP) levels > 8 mg/L were independent predictors linked to treatment failure.Conclusion: PA patients with severe inflammation and poor general health are usually treated with antifungal drugs only. Risk factors including elevated WBC levels and high CRP levels can help identify PA patients who may have a less favorable response to treatment at an early stage. It should be noted that increasing the dose and duration of antifungal therapy may improve patient prognosis.Keywords: pulmonary aspergillosis, antifungal treatment, surgery, treatment failure, prognosis
- Published
- 2025