Clinical Characteristics, Risk Factors and Outcomes of Invasive Fungal Disease in Critically III Patients with Hematological Malignancy: A Retrospective Study.

Abstract

Background: Invasive fungal disease (IFD) poses significant challenges for critically ill patients with hematological malignancies (HMs). However, there is limited research on the clinical characteristics, risk factors, and outcomes of IFD within this population.

Method: A retrospective study was conducted at a tertiary center in China. The study focused on patients with HMs admitted to the intensive care unit (ICU) between 2014 and 2022.

Results: A total of 239 patients were enrolled, among whom 105 (43.9%) were diagnosed with IFD. Further classification revealed that 64.8%, 31.4%, and 3.8% were classified as possible, probable, and proven IFD, respectively. Patients with IFD had significantly prolonged ICU stays compared to those without IFD (median: 4.9 vs. 2.9 days, P < .001). Notably, there was no statistically significant difference in 28-day mortality between the patients with and without IFD (44.8% vs. 54.5%, P = .907). Hypertension, mechanical ventilation (MV) duration exceeding 48 hours, and an extended interval between deterioration and ICU admission emerged as independent risk factors for IFD.

Conclusion: IFD is a common complication in critically ill patients with HM and is associated with prolonged length of ICU stay. Additionally, hypertension, prolonged MV duration and delayed ICU transfer are independent risk factors of IFD in these patients.