{"title":"患有侵袭性真菌性鼻炎的糖尿病患者的总生存率和预后因素。","authors":"Thwe Phyo Kan Nyunt, Baharudin Abdullah, Maung Maung Khaing, Kachorn Seresirikachorn, Norasnieda Md Shukri, Songklot Aeumjaturapat, Supinda Chusakul, Jesada Kanjanaumporn, Richard J Harvey, Kornkiat Snidvongs","doi":"10.12932/AP-310720-0934","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Patients with diabetes mellitus (DM) are susceptible to invasive fungal rhinosinusitis (IFRS). The mortality rate of IFRS varies greatly among the patients with DM.</p><p><strong>Objective: </strong>To identify the prognostic factors for the overall survival of patients with DM and IFRS.</p><p><strong>Methods: </strong>A retrospective study was conducted in four tertiary hospitals in Thailand, Malaysia and Myanmar. Patients diagnosed with IFRS and DM from 2008 to 2019 were identified. The outcome was the overall survival. Variables analyzed for risk factors were age, HbA1C level, ketoacidosis, white blood cell count, hyperglycemia, duration of DM, current use of diabetic medications, serum creatinine level, and the extensions of IFRS to the orbit, the cavernous sinus and intracranial cavity.</p><p><strong>Results: </strong>Sixty-five diabetic patients with IFRS (age 57.9 ± 13.4 years, male 60%) were identified. The mortality rate was 21.5%. The extensions of IFRS to the cavernous sinus (hazard ratio 5.1, 95% CI [1.4-18.2], p = 0.01) and intracranial cavity (hazard ratio 3.4, 95% CI [1.1-11.3, p = 0.05) predicted mortality. Current use of diabetic medications decreased the mortality risk (hazard ratio 0.2, 95% CI [0.1-0.9], p = 0.03). The 6-month overall survival of the patients with and without the cavernous sinus extension were 51.4% and 83.6%, (p = 0.001), with and without intracranial extension 53.3% and 88.9%, (p = 0.001), and with and without current diabetic medications 82.3% and 57.5%, respectively (p = 0.045).</p><p><strong>Conclusions: </strong>The extensions of IFRS to the cavernous sinus and intracranial cavity increased the risk of death in patients with DM. Survival was primarily related to current use of diabetic medications.</p>","PeriodicalId":8552,"journal":{"name":"Asian Pacific journal of allergy and immunology","volume":" ","pages":"347-352"},"PeriodicalIF":2.3000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Overall survival and prognostic factors in diabetic patients with invasive fungal rhinosinusitis.\",\"authors\":\"Thwe Phyo Kan Nyunt, Baharudin Abdullah, Maung Maung Khaing, Kachorn Seresirikachorn, Norasnieda Md Shukri, Songklot Aeumjaturapat, Supinda Chusakul, Jesada Kanjanaumporn, Richard J Harvey, Kornkiat Snidvongs\",\"doi\":\"10.12932/AP-310720-0934\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Patients with diabetes mellitus (DM) are susceptible to invasive fungal rhinosinusitis (IFRS). The mortality rate of IFRS varies greatly among the patients with DM.</p><p><strong>Objective: </strong>To identify the prognostic factors for the overall survival of patients with DM and IFRS.</p><p><strong>Methods: </strong>A retrospective study was conducted in four tertiary hospitals in Thailand, Malaysia and Myanmar. Patients diagnosed with IFRS and DM from 2008 to 2019 were identified. The outcome was the overall survival. Variables analyzed for risk factors were age, HbA1C level, ketoacidosis, white blood cell count, hyperglycemia, duration of DM, current use of diabetic medications, serum creatinine level, and the extensions of IFRS to the orbit, the cavernous sinus and intracranial cavity.</p><p><strong>Results: </strong>Sixty-five diabetic patients with IFRS (age 57.9 ± 13.4 years, male 60%) were identified. The mortality rate was 21.5%. The extensions of IFRS to the cavernous sinus (hazard ratio 5.1, 95% CI [1.4-18.2], p = 0.01) and intracranial cavity (hazard ratio 3.4, 95% CI [1.1-11.3, p = 0.05) predicted mortality. Current use of diabetic medications decreased the mortality risk (hazard ratio 0.2, 95% CI [0.1-0.9], p = 0.03). The 6-month overall survival of the patients with and without the cavernous sinus extension were 51.4% and 83.6%, (p = 0.001), with and without intracranial extension 53.3% and 88.9%, (p = 0.001), and with and without current diabetic medications 82.3% and 57.5%, respectively (p = 0.045).</p><p><strong>Conclusions: </strong>The extensions of IFRS to the cavernous sinus and intracranial cavity increased the risk of death in patients with DM. Survival was primarily related to current use of diabetic medications.</p>\",\"PeriodicalId\":8552,\"journal\":{\"name\":\"Asian Pacific journal of allergy and immunology\",\"volume\":\" \",\"pages\":\"347-352\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2023-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asian Pacific journal of allergy and immunology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.12932/AP-310720-0934\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Pacific journal of allergy and immunology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.12932/AP-310720-0934","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ALLERGY","Score":null,"Total":0}
引用次数: 1
摘要
背景:糖尿病(DM)患者易患侵袭性真菌性鼻炎(IFRS)。IFRS的死亡率在DM患者中差异很大:目的:确定DM和IFRS患者总生存率的预后因素:在泰国、马来西亚和缅甸的四家三级医院进行了一项回顾性研究。确定了2008年至2019年期间被诊断为IFRS和DM的患者。研究结果为总生存率。分析的风险因素变量包括年龄、HbA1C水平、酮症酸中毒、白细胞计数、高血糖、DM病程、目前使用的糖尿病药物、血清肌酐水平以及IFRS向眼眶、海绵窦和颅内腔的延伸:结果:共发现 65 名患有 IFRS 的糖尿病患者(年龄为 57.9 ± 13.4 岁,男性占 60%)。死亡率为 21.5%。IFRS延伸至海绵窦(危险比为5.1,95% CI [1.4-18.2],p = 0.01)和颅内腔(危险比为3.4,95% CI [1.1-11.3,p = 0.05)可预测死亡率。目前使用的糖尿病药物降低了死亡风险(危险比 0.2,95% CI [0.1-0.9],p = 0.03)。有海绵窦扩展和没有海绵窦扩展的患者的6个月总生存率分别为51.4%和83.6%(P = 0.001),有颅内扩展和没有颅内扩展的患者的6个月总生存率分别为53.3%和88.9%(P = 0.001),有糖尿病药物和没有糖尿病药物的患者的6个月总生存率分别为82.3%和57.5%(P = 0.045):结论:IFRS向海绵窦和颅内腔的扩展增加了糖尿病患者的死亡风险。存活率主要与目前使用的糖尿病药物有关。
Overall survival and prognostic factors in diabetic patients with invasive fungal rhinosinusitis.
Background: Patients with diabetes mellitus (DM) are susceptible to invasive fungal rhinosinusitis (IFRS). The mortality rate of IFRS varies greatly among the patients with DM.
Objective: To identify the prognostic factors for the overall survival of patients with DM and IFRS.
Methods: A retrospective study was conducted in four tertiary hospitals in Thailand, Malaysia and Myanmar. Patients diagnosed with IFRS and DM from 2008 to 2019 were identified. The outcome was the overall survival. Variables analyzed for risk factors were age, HbA1C level, ketoacidosis, white blood cell count, hyperglycemia, duration of DM, current use of diabetic medications, serum creatinine level, and the extensions of IFRS to the orbit, the cavernous sinus and intracranial cavity.
Results: Sixty-five diabetic patients with IFRS (age 57.9 ± 13.4 years, male 60%) were identified. The mortality rate was 21.5%. The extensions of IFRS to the cavernous sinus (hazard ratio 5.1, 95% CI [1.4-18.2], p = 0.01) and intracranial cavity (hazard ratio 3.4, 95% CI [1.1-11.3, p = 0.05) predicted mortality. Current use of diabetic medications decreased the mortality risk (hazard ratio 0.2, 95% CI [0.1-0.9], p = 0.03). The 6-month overall survival of the patients with and without the cavernous sinus extension were 51.4% and 83.6%, (p = 0.001), with and without intracranial extension 53.3% and 88.9%, (p = 0.001), and with and without current diabetic medications 82.3% and 57.5%, respectively (p = 0.045).
Conclusions: The extensions of IFRS to the cavernous sinus and intracranial cavity increased the risk of death in patients with DM. Survival was primarily related to current use of diabetic medications.
期刊介绍:
The Asian Pacific Journal of Allergy and Immunology (APJAI) is an online open access journal with the recent impact factor (2018) 1.747
APJAI published 4 times per annum (March, June, September, December). Four issues constitute one volume.
APJAI publishes original research articles of basic science, clinical science and reviews on various aspects of allergy and immunology. This journal is an official journal of and published by the Allergy, Asthma and Immunology Association, Thailand.
The scopes include mechanism, pathogenesis, host-pathogen interaction, host-environment interaction, allergic diseases, immune-mediated diseases, epidemiology, diagnosis, treatment and prevention, immunotherapy, and vaccine. All papers are published in English and are refereed to international standards.