Follow-up of Surgical and Nonsurgical Patients With Pulmonary Aspergillosis: A Real-World Study.

Objective: 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.