Sharma Aditya, Mohamad Bashar, Soubani Ayman O
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI 48201, USA.
Division of Gastroenterology, Wayne State University School of Medicine, Detroit, MI 48201, USA.
J Fungi (Basel). 2025 Apr 23;11(5):334. doi: 10.3390/jof11050334.
The aim of this study was to estimate the incidence and inpatient outcomes of liver failure and cirrhosis (LFC) admissions with invasive aspergillosis (IA) in the United States.
This retrospective cohort study utilized the 2016-2020 National Inpatient Sample (NIS) database to analyze outcomes of IA in LFC admissions. Baseline variables, including demographics, comorbidities, and complications, were identified using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes, and liver transplant admissions were excluded. Outcomes were compared between LFC admissions with and without IA.
During the study period, 9515 (0.36%) LFC admissions were associated with IA. This cohort experienced significantly higher rates of complications, including acute kidney injury (AKI) (73.36% vs. 42.96%; < 0.001) and acute respiratory failure (ARF) (65.74% vs. 24.85%; < 0.001). IA admissions required invasive mechanical ventilation (IMV) more frequently (58.17% vs. 18.78%; < 0.001). All-cause inpatient mortality was significantly higher in the aspergillosis group (43.40% vs. 15.75%; < 0.001). IA admissions had longer lengths of stay (LOS), with 38.89% exceeding 21 days compared to 6.20% ( < 0.001), and a mean LOS more than three times longer (22.9 vs. 7.5 days; < 0.001). The IA group incurred over four times higher hospital charges (USD 459,414.9 vs. USD 104,389.4; < 0.001) and hospitalization costs (USD 108,030.6 vs. USD 24,272.1; < 0.001) compared to the LFC without aspergillosis group.
LFC admissions with IA experienced poorer outcomes, longer hospital stays, and significantly higher healthcare costs, underscoring the need for targeted interventions in this high-risk, nonclassical population.
本研究旨在评估美国侵袭性曲霉病（IA）患者因肝衰竭和肝硬化（LFC）入院的发病率及住院结局。
本回顾性队列研究利用2016 - 2020年全国住院患者样本（NIS）数据库分析LFC入院患者中IA的结局。使用国际疾病分类第十版临床修订本（ICD - 10 - CM）编码确定基线变量，包括人口统计学、合并症和并发症，并排除肝移植入院患者。比较有IA和无IA的LFC入院患者的结局。
在研究期间，9515例（0.36%）LFC入院患者合并IA。该队列患者的并发症发生率显著更高，包括急性肾损伤（AKI）（73.36%对42.96%；<0.001）和急性呼吸衰竭（ARF）（65.74%对24.85%；<0.001）。合并IA的入院患者更频繁地需要有创机械通气（IMV）（58.17%对18.78%；<0.001）。曲霉病组的全因住院死亡率显著更高（43.40%对15.75%；<0.001）。合并IA的入院患者住院时间更长（LOS），38.89%的患者住院时间超过21天，而无IA组为6.20%（<0.001），平均住院时间超过三倍（22.9天对7.5天；<0.001）。与无曲霉病的LFC组相比，IA组的医院收费（459,414.9美元对104,389.4美元；<0.001）和住院费用（108,030.6美元对24,272.1美元；<0.001）高出四倍多。
合并IA的LFC入院患者结局较差，住院时间更长，医疗费用显著更高，这突出了对这一高风险、非典型人群进行针对性干预的必要性。
