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Table 2 Risk factors and adjusted effect estimates

From: Risk factors for invasive fungal disease in critically ill adult patients: a systematic review

Risk factors

Studies

OR (95% CI)

P-values

Surgery

   

   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

   

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

   

Digestive focus

Ibàñez-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

Ibàñez-Nolla et al., 2004 [31]

11.68 (1.93 to 70.63)

0.007

Respiratory focus

Ibàñez-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

   

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

   

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

   

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

   

   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

   

   APACHE II score

Pittet et al., 1994 [33]

1.03 (1.01 to 1.05)

0.007

   APACHE III score

Ibàñez-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

  1. APACHE = Acute Physiology and Chronic Health Evaluation; CPB = cardiopulmonary bypass; NR = not reported. α = OR for outcomes in Candida albicans; β = OR for outcomes in Candida non-albicans. aData combined from both articles from the EPCAN Study.