Candidiasis as a Potential Marker of Imminent Mortality in Palliative Care: A Retrospective Observational Study.

Abstract

Background: Predicting short-term mortality in patients receiving palliative care can help tailor interventions, manage expectations, and improve end-of-life planning. This study explores whether candidiasis, particularly in patients on corticosteroids, is associated with increased 30-day mortality.

Methods: We conducted a retrospective study of patients admitted to a specialized palliative care unit in 2022. Data collected included demographics, candidiasis diagnosis (oral/esophageal), corticosteroid use, and mortality. Patients with candidemia were excluded. Of 59 deaths in the unit, 35 had complete records and met inclusion criteria.

Results: Of the 35 patients analyzed, 71.4% were female; the median age was 61. Ten patients developed candidiasis, all with advanced cancer and functional decline. Among candidiasis cases, 30-day mortality was 60% versus 0% in those without. Median time from candidiasis diagnosis to death was 19 days. Among corticosteroid users, candidiasis was associated with significantly higher short-term mortality.

Conclusions: Candidiasis in patients receiving palliative care-particularly those on corticosteroids-may indicate imminent death. These findings suggest its potential as a simple prognostic marker in resource-limited settings, meriting further prospective validation.