From: Risk factors for invasive fungal disease in critically ill adult patients: a systematic review
Risk factors | Studies | OR (95% CI) | P-values |
---|---|---|---|
Surgery | Â | Â | Â |
   General abdominal surgery | Agvald-Ohman et al., 2008 [28] | 60.7 (7.3 to infinity) | 0.0013 |
   Any surgery | Blumberg et al., 2001 [29] | 7.3 (1 to 53.8) | 0.05 |
   Elective surgery | Jordà -Marcos et al., 2007 [26]a | 2.75 (1.17 to 6.45) | 0.02 |
   Surgery on ICU admission | León et al., 2006 [27]a | 2.71 (1.45 to 5.06) | < 0.001 |
   Gastrointestinal procedure | Chow et al., 2008 [30] | 2.24 (1.49 to 3.38)β | < 0.001β |
   Major pre-ICU operation | Chow et al., 2008 [30] | 2.12 (1.14 to 3.97)β | 0.02β |
   Major operation during ICU stay | Chow et al., 2008 [30] | 1.26α | 0.04α |
   Multiple surgical procedures | McKinnon et al., 2001 [32] | NR | ≤ 0.05 |
Total parenteral nutrition | Â | Â | Â |
Total parenteral nutrition duration/days at risk | Chow et al., 2008 [30] | 11 (5.52 to 21.7)α | < 0.01α |
 |  | 2.87 (1.4 to 5.9)β | < 0.01β |
   Total parenteral nutrition | Jordà -Marcos et al., 2007 [26]a | 3.89 (1.73 to 8.78) | 0.001 |
   Total parenteral nutrition | Blumberg et al., 2001 [29] | 3.6 (1.8 to 7.5) | < 0.001 |
   Total parenteral nutrition | León et al., 2006 [27]a | 2.48 (1.16 to 5.31) | < 0.001 |
   Total parenteral nutrition | Borzotta & Beardsley, 1999 [34] | NR | < 0.001 |
Fungal Colonisation | Â | Â | Â |
Digestive focus | Ibà ñez-Nolla et al., 2004 [31] | 20.24 (6.11 to 67.03) | < 0.001 |
Colonisation Index ≥ 0.5 | Agvald-Ohman et al., 2008 [28] | 19.1 (2.38 to 435) | 0.017 |
Non-Candida albicans at screening | Ibà ñez-Nolla et al., 2004 [31] | 11.68 (1.93 to 70.63) | 0.007 |
Respiratory focus | Ibà ñez-Nolla et al., 2004 [31] | 6.55 (1.25 to 34.3) | 0.026 |
Candida colonisation | Jordà -Marcos et al., 2007 [26]a | 4.12 (1.82 to 9.33) | 0.001 |
Candida colonisation | León et al., 2006 [27]a | 3.04 (1.45 to 6.39) | < 0.001 |
   Candida species corrected colonisation index | Pittet et al., 1994 [33] | 4.01 (2.16 to 7.45) | < 0.001 |
Renal replacement therapy | Â | Â | Â |
Haemodialysis duration/days at risk | Chow et al., 2008 [30] | 3.84 (1.75 to 8.4)α | < 0.001α |
 |  | 6.2 (2.67 to 14.4)β | < 0.0001β |
New-onset haemodialysis | Paphitou et al., 2005 [35] | 5.4 (2.5 to 11.8) | 0.029 |
Haemofiltration | Jordà -Marcos et al., 2007 [26]a | 1.96 (1.06 to 3.62) | 0.032 |
Infection/sepsis | Â | Â | Â |
Hospital acquired | Michalopoulos et al., 2003 [36] | 9.4 (2.5 to 48.3) | < 0.001 |
Severe sepsis | León et al., 2006 [27]a | 7.68 (4.14 to 14.22) | < 0.001 |
Enteric bacteraemia | Chow et al., 2008 [30] | 3.45 (1.38 to 8.63)α | < 0.01α |
 |  | 3.43 (1.39 to 8.48)β | < 0.01β |
Mechanical ventilation | Â | Â | Â |
Mechanical ventilation > 10 days | Michalopoulos et al., 2003 [36] | 28.2 (3.6 to 119.5) | < 0.001 |
Mechanical ventilation after day 3 | McKinnon et al., 2001 [32] | NR | ≤ 0.05 |
Diabetes | Â | Â | Â |
   Diabetes | Paphitou et al., 2005 [35] | 2.8 (1.6 to 4.7) | 0.053 |
   Diabetes | Michalopoulos et al., 2003 [36] | 2.4 (1.3 to 13.5) | < 0.01 |
APACHE II or APACHE III score | Â | Â | Â |
   APACHE II score | Pittet et al., 1994 [33] | 1.03 (1.01 to 1.05) | 0.007 |
   APACHE III score | Ibà ñez-Nolla et al., 2004 [31] | 1.03 (1.00 to 1.06) | 0.004 |
Cardiopulmonary bypass time > 120 min | Michalopoulos et al., 2003 [36] | 8.1 (2.9 to 23.6) | < 0.01 |
Acute renal failure | Blumberg et al., 2001 [29] | 4.2 (2.1 to 8.3) | < 0.001 |
Broad spectrum antibiotics | Paphitou et al., 2005 [35] | 3.0(1.8 to 5.0) | 0.028 |
Red blood cell transfusion | Chow et al., 2008 [30] | 1.97 (0.98 to 3.99)α | 0.06α |
 |  | 2.72 (1.33 to 5.58)β | < 0.01β |
Antifungal medication | Blumberg et al., 2001 [29] | 0.3 (0.1 to 0.6) | < 0.001 |
Central venous catheters | McKinnon et al., 2001 [32] | NR | ≤ 0.05 |
Diarrhoea | McKinnon et al., 2001 [32] | NR | ≤ 0.05 |
Peripheral catheter use | McKinnon et al., 2001 [32] | NR | ≤ 0.05 |