Premium
Paediatric Acute Invasive Fungal Sinusitis Outcomes Over a 13‐Year Period
Author(s) -
Wu Matthew James,
Munyemana MarieAnge,
Roland Lauren
Publication year - 2025
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.14310
Subject(s) - medicine , aspergillosis , mortality rate , sinusitis , fungal sinusitis , comorbidity , pediatrics , surgery , immunology
ABSTRACT Objectives To identify prognostic factors of paediatric acute invasive fungal sinusitis (AIFS) patients. Design Weighted cross‐sectional analysis over 13‐year period (2006–2019). Setting Public national hospitalisation database. Participants Immunocompromised paediatric (age < 21 years) patients with sinonasal fungal infection who underwent sinonasal surgical treatment. Main Outcome Measures Clinical characteristics (e.g., medical comorbidities, fungal species, age), mortality rate. Statistical Analysis To compare mortality rates, the Fisher's exact test was used for individual conditions, each fungal species, and hospital treatment setting. The sample's median age (12 years) divided patients into younger and older groups. For two‐sided tests, a p value of < 0.05 was considered significant. A Bonferroni correction was applied to evaluate fungal species and mortality, where a p value < 0.0167 was considered significant. Results A weighted total of 408 surgically treated AIFS patients were identified (median age 12 years). The most common immunocompromised comorbidities were neoplasms (75.7%) and hematologic disorders (71.2%). The most common fungal species were “other unspecified mycoses” as defined by ICD codes (53.8%) then mucormycoses (35%). The overall mortality rate was 16.1%. The only immunocompromised comorbidity associated with increased mortality was immunodeficiency disorders (25.3%; p = 0.023). Demographics associated with increased mortality were being male (12.3% vs. 3.9%; p = 0.004), but not older age (56.1% vs. 43.9%; p = 0.588). Patients with aspergillosis infections had increased mortality (26.2%; p = 0.003), but not other fungal species. Conclusion In the largest national sample of paediatric AIFS patients, the overall mortality rate was 16.1%. Negative prognostic indicators included male sex, immunodeficiency disorder, and aspergillosis infections.