Hospital prognosis of invasive pulmonary aspergillosis patients admitted to intensive care unit and one-year outcomes in hospital survivors:A retrospective longitudinal study

<bold>Background:</bold> Invasive pulmonary aspergillosis(IPA) usually occurs in immunosuppressed hosts. In intensive care unit (ICU) ,IPA is gradually recognized and also reported in non-immunosuppressed hosts. We aimed to analyse the hospital prognosis of IPA patients admitted to ICU and one-year outcomes in hospital survivors. <bold>Method:</bold> We performed a retrospective cohort study including critical patients admitted to ICU with IPA(modified AspICU critiria) utilizing the medical record system database from 2015.1 to 2023.5 in China-Japan Friendship Hospital, Beijing, China. Baseline data and outcomes were compared between ICU survial group and ICU non-survival group. Then used multivariate logistic regression analysis to identify risk factors that affect hospital prognosis. Subsequently, multivariable adjusted COX regression models were used to evaluate the risk factors of one-year outcomes in ICU IPA survivors. <bold>Results:</bold> 217 cases were collected from patients admitted to the ICU with IPA ,95 patients survived in ICU and 122 died in ICU. In the multivariate conditional logistic model, independent risk factors for ICU death in patients with IPA were advanced age, chronic lung diseases, history of glucocorticoid in the past 1 year,AKI and DIC occurence during ICU.173 hospital survivors with IPA completed 1-year follow-up, the one-year mortality rate was about 67.1%. Multivariate COX regression analysis showed shock,AKI,DIC in ICU,along with a higher SOFA score and lactic acid, may indicate a remarkable risk of death within 1 year. <bold>Conclusions:</bold> Clinicians may need to pay attention to multi-organ management to improve the outcomes of ICU IPA.