Epidemiology, clinical characteristics, and outcome of candidemia in critically ill patients in Germany: a single-center retrospective 10-year analysis

Annals of Intensive Care

Table 3 Probability of death 28 and 180 days after blood cultures were tested positive for Candida spp. 381 observations, 178 events (28 days), and 227 events (180 days) were included in the multivariable analysis

Probability of death	At 28 days		At 180 days
Variable	Hazard ratio	95% CI	Hazard ratio	95% CI
Age (per year increase)	1.02	1.00–1.03	1.02	1.01–1.03
Liver cirrhosis (vs. none)	1.61	1.09–2.38	1.54	1.07–2.20
Immunosuppression^a (vs. none)	0.97	0.71–1.32	0.84	0.63–1.11
SOFA score (per point increase)	1.14	1.08–1.19	1.12	1.07–1.17
Septic shock	2.60	1.77–3.82	2.41	1.73–3.37
Admission diagnosis
Abdominal surgery vs. medical	0.55	0.38–0.81	0.66	0.48–0.91
Other surgery vs. medical	0.79	0.52–1.20	0.70	0.48–1.03
Abdominal surgery vs. other surgery	1.43	0.89–2.30	1.06	0.71–1.60
Days at ICU before Candida BSI (per day increase)	1.01	1.00–1.01	1.01	1.00—1.01
Mechanical ventilation (vs. none)	0.95	0.49–1.82	0.77	0.44–1.34
Extracorporeal organ support before Candida BSI (vs. none)	1.23	0.85–1.78	1.28	0.93–1.76
Mean CVC duration (per h increase)	1.00	1.00–1.00	1.00	1.00–1.00
Candida score (per point increase)	1.21	1.06–1.37	1.25	1.11–1.40
Candida species (albicans vs. non-albicans)	1.14	0.82–1.59	1.08	0.80–1.44
Treatment with echinocandins (vs. none or other antifungals)	0.67	0.45–0.99	0.79	0.56–1.11
Antifungal treatment:
Non-adequate vs. none	0.23	0.10–0.56	0.31	0.16—0.62
Adequate vs. none	0.30	0.20–0.45	0.36	0.24–0.52
Adequate vs. non-adequate	0.78	0.34–1.81	0.88	0.47–1.65

SAPS II: Simplified Acute Physiology Score II at time of culture positivity. ICU: intensive care unit. BSI: bloodstream infection. CVC: central venous catheter. SOFA score: Sepsis-related organ failure assessment score. ^aImmunosuppression: stem cell transplantation, acquired immunodeficiency syndrome, solid organ transplantation, immunosuppressive medication. The criteria for adequate antifungal treatment were fulfilled, if (1) antifungal medication was administered within the first 24 h of culture positivity, (2) substance dosage was weight adjusted and in accordance with current recommendations, (3) the isolated yeast was susceptible to the antifungal agent, and (4) source control was initiated within the first 48 h after blood culture positivity