Baseline parameters of survival in chronic pulmonary aspergillosis

Ref ID: 19495

Author:

D Lowes1*, K Al-Shair1, C Harris1, R Rautemaa-Richardson1, DW Denning1

Author address:

1The National Aspergillosis Centre, The University of Manchester, Manchester, UK

Full conference title:

6th Advances Against Aspergillosis 2014

Abstract:

Background:
Chronic pulmonary aspergillosis (CPA) is a chronic, usually progressive infection in nonimmucompromised
patients. Many underlying pulmonary diseases are associated with CPA.
Contemporary series suggest a 75-85% 5 year mortality.
Methods:
Data from 392 patients treated for CPA at the UK’s National Aspergillosis Centre (NAC) prior to
June 2012 were retrospectively analysed. The impact of age, sex, previous pulmonary conditions,
dyspnea score, quality of life score and radiological appearances was assessed using Kaplan-Meier
curves, Log-Rank tests and the Cox proportional hazards modelling. A sample of patient notes were
used to examine the medical history and estimate the onset of CPA and the time taken from onset to
referral to the NAC. Cause of death was recorded were possible. Statistical analysis was performed
using IBM SPSS statistics package version 20. The project was registered with the hospital trust’s
clinical audit department.
Results:
The mean age at referral was 59.4 years (range 18 to 86 years), 59.4% were males. Survival of
patients with CPA at the NAC was 86% at one year from referral, and 57% at five years. Subgroups
with worse prognosis included those with a history of non-tuberculous Mycobacterium
infection (p=<0.000). Age at referral was a strong predictor of mortality (Hazard ratio 1.058 per year, p=<0.000). The median time from estimated onset of CPA to referral to the NAC was 8 months (range 0 to 21 years). Discussion: A number of factors associated with increased risk of mortality from CPA were identified. The survival of CPA patients treated at NAC was better than reported previously by others. The longterm antifungal therapy approach undertaken at the NAC may contribute to this. Survival of patients may be under-estimated due to some patients presenting many years after the probable onset of disease.

Abstract Number: 23

Conference Year: 2014

Link to conference website: http://www.AAA2014.org

New link: NULL

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