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How Has the Aspergillosis Case Fatality Rate Changed over the Last Two Decades in Spain?
Pablo González-García1, Montserrat Alonso-Sardón2, Beatriz Rodríguez-Alonso3
1Servicio de Medicina Interna, Hospital Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, 39008 Santander, Spain.
Abstract:
(1) Background: Aspergillus produces high morbidity and mortality, especially in at-risk populations. In Spain, the evolution of mortality in recent years due to this fungus is not well established. The aim of this study was to estimate the case fatality rate of aspergillosis in inpatients from 1997 to 2017 in Spain. (2) Methodology: A retrospective descriptive study was conducted with records of inpatients admitted to the National Health System with a diagnosis of aspergillosis. (3) Principal findings: Of 32,960 aspergillosis inpatients, 24.5% of deaths were registered, and 71% of the patients who died were men. The percentage of deaths increased progressively with age. The case fatality rate progressively decreased over the period, from 25.4 and 27.8% in 1997-1998 to values of 20.6 and 20.8% in 2016 and 2017. Influenza and pneumonia occurrence/association significantly increased case fatality rates in all cases. (4) Conclusions: Our study shows that lethality significantly decreased in the last two decades despite the increase in cases. This highlights the fact that patients with solid and/or hematological cancer do not have a much higher mortality rate than the group of patients with pneumonia or influenza alone, these two factors being the ones that cause the highest CFRs. We also need studies that analyze the causes of mortality to decrease it and studies that evaluate the impact of COVID-19.
Insights
The case fatality rate of invasive aspergillosis in Spain decreased significantly between 1997 and 2017, despite an increase in cases. Influenza and pneumonia were associated with higher mortality rates.
Area of Science:
- Medical Mycology
- Infectious Diseases Epidemiology
- Public Health Surveillance
Background:
- Invasive aspergillosis poses a significant health threat, particularly to immunocompromised individuals.
- Mortality trends for aspergillosis in Spain have not been well-documented.
- Understanding aspergillosis lethality is crucial for public health interventions.
Purpose of the Study:
- To determine the case fatality rate (CFR) of invasive aspergillosis among hospitalized patients in Spain.
- To analyze trends in aspergillosis-related mortality from 1997 to 2017.
- To identify factors influencing mortality in aspergillosis patients.
Main Methods:
- Retrospective descriptive study design.
- Utilized inpatient records from the Spanish National Health System.
- Analyzed data from 32,960 patients diagnosed with aspergillosis between 1997 and 2017.
Main Results:
- Overall mortality for aspergillosis was 24.5%, with higher rates in men and increasing with age.
- The case fatality rate demonstrated a decreasing trend, from over 25% in 1997-1998 to approximately 20.7% in 2016-2017.
- Concomitant influenza or pneumonia significantly elevated aspergillosis mortality rates.
Conclusions:
- Aspergillosis lethality in Spain has decreased over the past two decades, indicating improved patient outcomes.
- Patients with solid or hematological cancers did not exhibit significantly higher mortality than those with influenza or pneumonia alone.
- Further research is needed to elucidate specific mortality causes and the impact of COVID-19 on aspergillosis outcomes.
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