Characteristics and outcomes of chronic pulmonary aspergillosis: a retrospective analysis of a tertiary hospital registry. (17th February 2014)

• Record Type: Journal Article
• Authors: Camara, Boubou; Reymond, Emilie; Saint‐Raymond, Christel; Roth, Hubert; Brenier‐Pinchart, Marie‐Pierre; Pinel, Claudine; Cadranel, Jacques; Ferretti, Gilbert; Pelloux, Hervé; Pison, Christophe; Grenoble Aspergillus Committee
• Is Part Of: Clinical respiratory journal. Volume 9:Number 1(2015)
• Page Start: 65
• Page End: 73
• Publication Date: 2014-02-17
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Periodicals; 616.24
• DOI: 10.1111/crj.12105
• Languages: English
• ISSNs: 1752-6981

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="crj12105-sec-0001" sec-type="section"> <title>Introduction</title> <p>Our objective was to investigate characteristics risk factors and outcomes of patients with chronic pulmonary aspergillosis (CPA).</p> </sec> <sec id="crj12105-sec-0002" sec-type="section"> <title>Methods</title> <p>The Aspergillosis Committee prospectively collected <italic>Aspergillus</italic> notifications from January 2000 to December 2011. A retrospective analysis of data was performed.</p> </sec> <sec id="crj12105-sec-0003" sec-type="section"> <title>Results</title> <p>Among 1614 notifications registered, 44 cases of CPA in non‐immunocompromised patients were identified. The median age was 65 years (Q1–Q3: 54–75), the median body mass index (BMI) was 20 kg/m<sup>2</sup> (Q1–Q3: 16–22) and 15 had chronic obstructive pulmonary disease. All patients had a positive specific serum precipitin antibody titer. Radiological presentations were: cavitations [single <italic>n</italic> = 31 (70%); multiple <italic>n</italic> = 12 (27%)] containing mycetomas [<italic>n</italic> = 18 (41%)], consolidations [<italic>n</italic> = 19 (43%)], emphysema [<italic>n</italic> = 15 (34%)] and sequelae of mycobacterial infection [<italic>n</italic> = 10 (23%)]. The median duration of follow‐up was 30 months (Q1–Q3: 14–55). The median duration of antifungal treatment was 6 months (Q1–Q3: 3–12). Outcomes were unfavorable in 14 patients, and 12 (27%) died. Analysis by multivariate Cox regression model with bootstrapping showed that a higher BMI and a lower Charlson index score were predictive of favorable evolution, hazard ratio (95% confidence interval): BMI (+1) = 0.83 (0.71–0.97), Charlson (+1) = 1.37 (1.01–1.85). When analyses were restricted to chronic CPA and chronic necrotizing pulmonary aspergillosis, the multivariate Cox regression model showed that both BMI and Charlson index score were not statistically significant.</p> </sec> <sec id="crj12105-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Our results provide data on clinical characteristics and outcomes of CPA emphasizing the role of preexisting chronic respiratory conditions and protective effect of preserved BMI and lower Charlson index score.</p> </sec> </abstract>