Background
Materials and methods
Inclusion criteria and study design
Statistical analysis
Results
Patient characteristics
Characteristic | Child–Pugh classification | Total (N = 200, %) | P | Statistic (X2/F) | |||
---|---|---|---|---|---|---|---|
A (n = 66) | B (n = 83) | C (n = 51) | |||||
Sex | Female | 36 | 48 | 36 | 120 (60) | 0.186 | 3.363 |
Age | M (P25-P75) | 58 (42–72) | 59 (48–68) | 49 (43–61) | – | 0.015 | 4.319 |
Weight | M (P25-P75) | 56.6 (50–66) | 58.6 (50–65) | 58.6 (54–65) | – | 0.376 | 0.984 |
Period of treatment | 1 week | 26 | 36 | 17 | 79 (39.5) | 0.514 | 1.333 |
2 weeks | 22 | 28 | 22 | 72 (36) | 0.469 | 1.516 | |
3 weeks | 18 | 19 | 12 | 49 (24.5) | 0.812 | 0.416 | |
Department | Infectious Diseases | 6 | 24 | 44 | 74 (37) | 0.000 | 77.503 |
Hematology | 36 | 20 | 1 | 57 (28.5) | 0.000 | 40.389 | |
ICU | 2 | 13 | 1 | 16 (8) | 0.003 | 11.364 | |
Respiratory | 4 | 12 | 4 | 20 (10) | 0.198 | 3.234 | |
Nephrology | 3 | 2 | 0 | 5 (2.5) | 0.375 | 2.091 | |
Rheumatology and Immunology | 2 | 2 | 0 | 4 (2) | 0.683 | 1.310 | |
Others | 13 | 10 | 1 | 24 (12) | 0.014 | 8.570 | |
Underlying disease | Cirrhosis of the liver | 0 | 10 | 41 | 51 (25.5) | 0.000 | 111.386 |
Haematological malignancy | 34 | 19 | 1 | 54 (27) | 0.000 | 37.058 | |
Severe pulmonary disease | 11 | 24 | 2 | 37 (18.5) | 0.001 | 13.308 | |
Cancer | 6 | 14 | 0 | 20 (10) | 0.008 | 10.077 | |
Sepsis | 1 | 0 | 5 | 6 (3) | 0.003 | 8.708 | |
Acute pancreatitis | 1 | 3 | 1 | 5 (2.5) | 0.853 | 0.719 | |
Solid organ transplantation | 4 | 0 | 0 | 4 (2) | 0.015 | 5.941 | |
Autoimmune disease | 3 | 2 | 0 | 5 (2.5) | 0.375 | 2.091 | |
Chronic kidney disease | 2 | 1 | 0 | 3 (1.5) | 0.616 | 1.509 | |
Atherosclerotic vascular disease | 2 | 1 | 0 | 3 (1.5) | 0.616 | 1.509 | |
Others | 2 | 9 | 1 | 12 (6) | 0.077 | 5.103 | |
Risk-factor for fungal infection | Broad-spectrum antibiotic | 64 | 81 | 51 | 196 (98) | 0.683 | 1.310 |
Corticosteroid | 39 | 42 | 2 | 83 (41.5) | 0.000 | 40.910 | |
Immunosuppression | 25 | 19 | 2 | 46 (23) | 0.000 | 18.733 | |
Central venous line | 31 | 42 | 33 | 106 (53) | 0.142 | 3.960 | |
Recent surgery | 5 | 12 | 1 | 18 (9) | 0.041 | 6.268 | |
Tracheal intubation | 8 | 31 | 6 | 45 (22.5) | 0.000 | 17.943 | |
Malignancy | 6 | 14 | 2 | 22 (11) | 0.055 | 5.775 | |
Diabete | 12 | 12 | 4 | 28 (14) | 0.285 | 2.579 | |
Transplant recipient | 4 | 0 | 0 | 4 (4) | 0.015 | 5.941 | |
HIV | 0 | 2 | 1 | 3 (1.5) | 0.481 | 1.560 | |
Hepatoprotective drugs | Yes | 35 | 60 | 48 | 143 (71.5) | 0.000 | 18.074 |
Diagnostic grades of IFI Infection site | Confirmed | 2 | 8 | 2 | 12 (6) | 0.023 | 3.319 |
Clinical diagnosis | 31 | 47 | 36 | 114 (57) | 0.038 | 6.556 | |
Suspected diagnosis | 33 | 28 | 13 | 74 (37) | 0.018 | 8.063 | |
Pulmonary | 54 | 58 | 27 | 139 (69.5) | 0.003 | 12.327 | |
Digestive tract | 10 | 16 | 22 | 48 (24) | 0.001 | 14.088 | |
Blood | 1 | 5 | 1 | 7 (3.5) | 0.260 | 2.693 | |
Urinary tract | 0 | 1 | 1 | 2 (1) | 0.725 | 1.408 | |
Others | 1 | 3 | 0 | 4 (2) | 0.462 | 1.681 |
Dose and duration of treatment
Changes of liver and kidney function
Group | Time | albumin g/L | ALT U/L | AST U/L | ALP U/L | GGT U/L | TBIL U/L | Scr mmol/L | eGFR ml/min |
---|---|---|---|---|---|---|---|---|---|
A | D0 D1 D7 X2 P | 33.7 (29–37) 33.3 (30–35) 31.4 (29–33) 5.79 0.06 | 28.0 (13–60) 24.5 (12–71) 21.5 (12–41) 2.80 0.25 | 20.0 (16–40) 20.5 (13–38) 22.5 (13–40.) 3.98 0.14 | 85.0 (72–133) 85.5 (60–124) 80.0 (63–108) 9.41 0.01 | 68.0 (31–191) 67.0 (29–172)* 52.0 (22–100)*# 14.00 0.01 | 9.0 (5–13) 8.8 (5–12) 7.9 (6–11) 1.17 0.56 | 62.9 (53–85) 60.9 (48–86) 61.0 (45–71) 6.39 0.04 | 78.8 (52–96) 87.7 (60–107) 94.9 (63–120) 5.43 0.06 |
B | D0 D1 D7 X2 P | 30.0 (28–32) 29.3 (26–32) 29.9 (28–32) 1.69 0.43 | 37.5 (16–80) 36.0 (12–71) 27.5 (14–59) 1.922 0.382 | 48.5 (27–84) 45.5 (23–99) 60.1 (25–86) 0.75 0.69 | 115.5 (68–147) 114.5 (70–154) 112.0 (90–209) 0.14 0.93 | 83.0 (29–165) 88.0 (34–153) 92.5 (37–143) 2.02 0.37 | 21.1 (10–42) 13.8 (8–40) 18.2 (8–36) 3.32 0.21 | 68.7 (56–100) 77.0 (50–106) 81.8 (58–112) 0.39 0.82 | 81.6 (46–106) 79.4 (45`104) 77.4 (37–98) 0.2 0.91 |
C | D0 D1 D7 X2 P | 30.6 (25–34) 30.0 (27–35) 31.0 (27–34) 0.22 0.89 | 21.0 (16–32) 22.0 (14–32) 17.0 (10–41) 0.456 0.796 | 48.0 (28–85) 44.0 (30–65) 55.0 (33–117) 2.63 0.27 | 88.0 (71–171) 77.0 (67–157) 86.0 (68–153) 5.52 0.06 | 37.0 (25–85) 37.0 (24–60) 46.0 (23–66) 7.18 0.03 | 163.0 (51–324) 156.0 (67–276) 162.0 (62–308) 0.65 0.72 | 89.0 (54–146) 83.4 (62–168) 79.9 (64–142) 0.78 0.68 | 69.6 (30–91) 69.7 (32–97) 65.0 (36–86) 1.00 0.61 |
Group | Time | Albumin g/L | ALT U/L | AST U/L | ALP U/L | GGT U/L | TBIL U/L | Scr mmol/L | eGFR mL/min |
---|---|---|---|---|---|---|---|---|---|
A | D0 D1 D7 D14 X2 P | 31.8 (29–35) 32.4 (29–34) 30.1 (26–33) 31.6 (29–37) 6.39 0.09 | 17.5 (8–35) 16.0 (9–31) 25.5 (14–48) 19.5 (12–36) 3.38 0.29 | 19.5 (16–28) 16.5 (13–26) 20.0 (15–26) 22.0 (12–35) 4.91 0.18 | 89.0 (59–113) 86.0 (74–118) 94.7 (81–103) 96.0 (64–128) 1.41 0.70 | 38.0 (19–92) 42.0 (27–84) 38.5 (26–61) 36.0 (22–82) 2.08 0.56 | 8.6 (6–15) 8.8 (5.5–14) 10.7 (6–15) 11.1 (9–19) 2.35 0.50 | 56.4 (47–131) 57.4 (45–108) 69.0 (44–115) 65.5 (42–126) 0.60 0.89 | 86.8 (38–130) 88.6 (38–139) 88.4 (41–131) 85.9 (31–145) 0.96 0.81 |
B | D0 D1 D7 D14 X2 P | 28.1 (26–31) 27.6 (25–29) 29.5 (27–31) 30.1 (27–34)# 13.03 0.005 | 26.0 (14–68) 27.0 (12–50) 28.0 (10–41) 20.5 (11–37) 9.24 0.03 | 42.5 (23–56) 44.5 (24–59) 38.0 (25–61) 32.0 (20–52) 9.92 0.03 | 110.0 (71–174) 116.0 (72–175) 115.5 (74–182) 134.0 (69–186) 1.14 0.77 | 79.5 (46–129) 82.5 (49–134) 79.0 (49–123) 63.5 (41–86) 5.04 0.17 | 20.5 (10–52) 17.4 (13–67) 25.1 (10–55) 18.6 (9–48) 4.99 0.17 | 77.7 (48–112) 65.7 (48–98) 49.5 (37–80)*# 58.3 (39–80)*# 28.05 0.00 | 85.1 (42–105) 81.4 (48–100) 103.9 (65–134) *# 105.4 (59–138) *# 22.6 0.00 |
C | D0 D1 D7 D14 X2 P | 29.1 (26–32) 30.1 (27–33) 30.7 (28–33) 31.8 (27–34) 2.29 0.51 | 49.5 (35–91) 50.0 (26–110) 45.0 (22–73) 37.0 (21–73) 9.65 0.02 | 76.0 (56–123) 73.0 (53–113) 81.5 (49–117) 71.0 (42–98) 2.18 0.54 | 135.0 (100–164) 132.0 (110–171) 117.0 (73–150) 115.0 (93–150) 6.08 0.11 | 51.0 (30–81) 51.0 (28–91) 56.0 (34–80) 46.0 (30–74) 0.19 0.76 | 240.9 (110–371) 263.1 (88–388) 227.3 (109–335) 196.0 (64–332) 3.61 0.31 | 71.3 (52–101) 65.5 (43–80) 61.4 (41–77) 68.9 (54–91) 1.33 0.72 | 102.9 (59–136) 106.9 (71–144) 110.5 (59–139) 104.8 (60–130) 0.88 0.83 |
Group | Time | Albumin g/L | ALT U/L | AST U/L | ALP U/L | GGT U/L | TBIL U/L | Scr mmol/L | eGFR mL/min |
---|---|---|---|---|---|---|---|---|---|
A | D0 D1 D7 D14 D21 X2 P | 31.7 (28–35) 29.5 (27–32) 30.1 (28–32) 30.2 (29–32) 29.5 (29–35) 4.57 0.33 | 19.0 (8–28) 15.0 (10–43) 16.0 (9–26) 20.0 (9–31) 21.0 (9–38) 0.65 0.96 | 18.0 (11–25) 19.0 (11–28) 21.0 (13–28) 20.0 (12–28) 27.0 (13–34) 1.48 0.83 | 72.0 (55–109) 81.0 (58–122) 84.0 (59–114) 82.0 (61–124) 76.0 (67–123) 4.15 0.48 | 45.0 (23–119) 51.0 (18–129) 36.0 (19–101) 39.0 (26–81) 39.0 (25–56) 1.71 0.79 | 7.8 (5–18) 7.2 (5–17) 7.6 (5–15) 8.3 (6–13) 8.2 (6–12) 1.21 0.87 | 78.2 (55–105) 65.7 (54–100) 67.1 (57–108) 62.5 (51–90) 54.7 (45–86) 7.51 0.11 | 85.5 (31–152) 93.4 (41–142) 83.5 (27–125) 94.0 (37–145) 95.6 (36–146) 8.08 0.08 |
B | D0 D1 D7 D14 D21 X2 P | 28.0 (26–32) 27.1 (26–28) 30.1 (29–32) 31.6 (29–34)# 31.1 (29–33)# 17.26 0.002 | 15.0 (11–55) 22.0 (8–57) 17.0 (11–48) 25.0 (9–56) 23.5 (13–47) 1.65 0.79 | 24.0 (14–50) 24.0 (13–76) 22.0 (12–48) 23.0 (10–52) 22.0 (16–32) 3.07 0.45 | 97.0 (63–140) 106.0 (67–137) 118.0 (71–176) 103.0 (72–201) 86.0 (70–208) 4.61 0.33 | 67.0 (32–181) 63.1 (26–166) 48.0 (20–178) 87.0 (19–133) 72.0 (23–169) 2.19 0.70 | 7.7 (6–11) 9.0 (4–12) 9.3 (6–11) 10.6 (8–16) 9.0 (6.1–14) 4.60 0.33 | 67.9 (51–118) 62.2 (48–118)* 58.9 (45–94) 52.7 (23–71) 53.5 (41–76) 12.54 0.01 | 70.5 (38–110) 81.4 (42–125) 90.9 (56–133) 99.6 (43–132) *# 106.1 (37–135) *# 11.1 0.02 |
C | D0 D1 D7 D14 D21 X2 P | 29.4 (28–31) 29.6 (29–31) 30.5 (30–32) 31.0 (30–32) 33.0 (32–35) 9.08 0.06 | 44.0 (16–71) 26.0 (10–52) 18.0 (11–41) 22.0 (11–41) 20.0 (15–40) 1.93 0.75 | 56.0 (44–159) 56.0 (33–106) 55.0 (41–92) 47.0 (33–63) 55.0 (34–84) 2.94 0.57 | 145.0 (99–163) 130.0 (116–155) 122.0 (91–157) 121.0 (112–160) 123.0 (92–189) 3.34 0.50 | 54.0 (30–82) 51.0 (30–68) 41.0 (24–87) 47.0 (31–68) 42.0 (25–70) 1.72 0.79 | 310.6 (121–400) 276.5 (121–417) 284.5 (110–393) 184.0 (119–358) 171.4 (121–407) 5.49 0.24 | 60.5 (47–386) 60.5 (54–199) 68.1 (43–114) 53.5 (45–87) 60.1 (42–75) 3.36 0.49 | 77.8 (14–128) 69.8 (3–128) 96.8 (53–147) 87.4 (47–130) 93.8 (61–116) 3.58 0.46 |
The outcomes of treatment
Group | Complete response | Partial response | Stable response | Progression of disease | Death | Efficient (%) |
---|---|---|---|---|---|---|
A B C X2 P Total | 2 3 5 2.939 0.245 10 | 46 48 22 8.333 0.016 116 | 8 9 11 3.307 0.212 28 | 7 9 6 0.043 1.000 22 | 3 14 7 5.479 0.067 24 | 72.7 61.4 52.9 7.438 0.114 63.0 |
Group | Complete response | Partial response | Stable response | Progression of disease | Death | Efficient (%) |
---|---|---|---|---|---|---|
1 week 2 weeks 3 weeks X2 P | 4 5 1 1.269 0.652 | 46 40 30 6.998 0.030 | 12 10 5 1.985 0.369 | 9 8 6 0.700 0.715 | 8 9 8 0.690 0.711 | 63.3 62.5 63.3 1.416 0.084 |
Total | 10 | 116 | 27 | 22 | 25 | 63.0 |