Related Experiment Video
Updated: Jan 23, 2026
Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia
Published on: February 17, 2023
Proportion, Morbidity, and Mortality of Acute Invasive Fungal Rhinosinusitis in Immunocompromised Populations: A
Estephania Candelo1,2, Srivatsa Surya Vasudevan1, Gene C Osuoha3
1Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic Jacksonville, Jacksonville, Florida.
Importance:
Acute invasive fungal rhinosinusitis (AIFRS) is a rapidly progressive and potentially life-threatening infection that predominantly affects immunocompromised patients. Recent advances in diagnostic imaging, antifungal therapy, and surgical techniques may have altered its incidence, morbidity, and mortality.
Objective:
To evaluate temporal trends in the pooled proportion, morbidity, and mortality of AIFRS in immunocompromised patients and assess the association of diagnostic and therapeutic advances.
Data Sources:
Systematic searches of Ovid MEDLINE, Ovid Embase, PubMed, Scopus, Web of Science, Cochrane, and Google Scholar from 1977 through October 20, 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Study Selection:
Prospective, retrospective, and cross-sectional studies and case series reporting pooled proportion, morbidity, or mortality of AIFRS in immunocompromised patients were included. Non-English articles, reviews, editorials, and studies with fewer than 10 patients were excluded.
Data Extraction And Synthesis:
Two independent reviewers extracted data using standardized templates; disagreements were resolved by consensus. Risk of bias was assessed using the Newcastle-Ottawa Scale and Murad tool for case series. Random-effects meta-analysis generated pooled proportion, morbidity, and mortality rates with 95% CIs. Heterogeneity was quantified using I2 statistics. Meta-regression and sensitivity analyses evaluated temporal trends and study-level effects.
Main Outcomes And Measures:
Pooled proportion, morbidity, and mortality rates of AIFRS stratified by publication period (1983-2012 vs 2013-2025).
Results:
A total of 205 studies comprising 48 437 immunocompromised patients (median [range] age, 49.4 [5.2-68.8] years), including 10 311 (21.3%) with AIFRS, were analyzed. The pooled proportion was 11.8% (95% CI, 7.9%-17.2%), rising to 16.6% (95% CI, 8.7%-29.2%) in studies from 2013 to 2025. Overall mortality was 31.2% (95% CI, 28.3%-34.3%), declining from 41.9% (95% CI, 35.0%-49.1%) before 2013 to 28.2% (95% CI, 25.1%-31.4%) after 2013. Morbidity was 37.0% (95% CI, 32.9%-41.4%), with similar rates across periods (39.3% before 2013 vs 36.4% after 2013). The most common complications were vision loss, exophthalmos/proptosis, and orbital exenteration.
Conclusions And Relevance:
This systematic review and meta-analysis suggests that the pooled proportion of AIFRS among immunocompromised patients has increased while mortality has declined, reflecting advances in diagnostic and therapeutic approaches. Early detection and aggressive management remain critical to improving outcomes.
Insights
Acute invasive fungal rhinosinusitis (AIFRS) is increasing in immunocompromised patients, but mortality rates have decreased due to improved treatments. Early detection and management are crucial for better outcomes in AIFRS cases.
Area of Science:
- Infectious Diseases
- Otolaryngology
- Immunology
Background:
- Acute invasive fungal rhinosinusitis (AIFRS) is a severe infection primarily affecting immunocompromised individuals.
- Recent advancements in diagnostics, antifungal therapies, and surgical interventions may impact AIFRS outcomes.
Purpose of the Study:
- To analyze temporal trends in AIFRS incidence, morbidity, and mortality among immunocompromised patients.
- To assess the influence of diagnostic and therapeutic progress on AIFRS outcomes.
Main Methods:
- A systematic review and meta-analysis of studies published from 1977 to 2025.
- Inclusion of prospective, retrospective, cross-sectional studies, and case series with at least 10 patients.
- Data extraction and synthesis using standardized templates and random-effects meta-analysis.
Main Results:
- Analysis of 205 studies involving 48,437 patients revealed a pooled AIFRS proportion of 11.8%, increasing to 16.6% in studies from 2013-2025.
- Overall mortality decreased from 41.9% before 2013 to 28.2% after 2013.
- Morbidity rates remained stable (39.3% vs. 36.4%), with common complications including vision loss and proptosis.
Conclusions:
- The incidence of AIFRS in immunocompromised patients has risen, while mortality has declined, suggesting improved management strategies.
- Despite advances, AIFRS remains a significant threat, underscoring the need for early diagnosis and aggressive treatment.
More Related Videos
08:36Author Spotlight: Evaluating the Adjuvant Efficacy and Safety of Angong Niuhuang Pill in Viral Encephalitis Treatment
Published on: April 19, 2024
05:16Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Related Concept Videos
01:20Sample Proportion and Population Proportion
01:24Testing a Claim about Population Proportion
There are two methods of testing a claim about a population proportion: (1) Using the sample proportion from the data where a binomial distribution is approximated to the normal distribution and (2) Using the binomial probabilities calculated from the data.
The first method uses normal distribution as an approximation to the binomial distribution. The requirements are as follows: sample size is large...
01:10Review and Preview
Percentiles are a type of fractile that partition data into...
01:13Review and Preview
01:12Analysis of Population Pharmacokinetic Data
02:04Conservation of Small Populations