Has the mortality from pulmonary mucormycosis changed over time? A systematic review and meta-analysis.

作者: Inderpaul Singh Sehgal , Ritesh Agarwal , Ashutosh N. Aggarwal , Valliappan Muthu , Arunaloke Chakrabarti

DOI: 10.1016/J.CMI.2020.12.035

关键词: Meta-analysisConfidence intervalDisseminated diseaseSample size determinationRisk factorFungal pneumoniaAbsolute risk reductionDiabetes mellitusInternal medicineMedicine

摘要: Abstract Objectives Pulmonary mucormycosis (PM) is increasingly being reported in immunocompromised patients and has a high mortality. Our aim was to assess the mortality of PM its trend over time. We also evaluated role combined medical–surgical therapy PM. Methods performed systematic review Pubmed, Embase, Cochrane central databases. Studies were eligible if they described at least five confirmed cases assessed effect versus medical treatment alone on used random-effects model estimate pooled compared it across three time periods. The factors influencing using meta-regression. risk difference (RD) death following: subjects undergoing alone, with isolated disseminated disease, diabetes mellitus (DM) non-DM as factor. Results included 79 studies (1544 subjects). 57.1% (95% confidence interval [CI] 51.7–62.6%). Mortality improved significantly (72.1% 58.3% 49.8% for before 2000, 2000–2009, 2010–2020, respectively, p 0.00001). This survival meta-regression after adjusting study design, country's income level, sample size. Combined associated lower RD (95%CI) death: –0.32 (–0.49 –0.16). disease had higher than PM, but DM not other factors. Conclusions While still mortality, we noted alone.

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