Epidemiology and Inpatient Outcomes of Invasive Aspergillosis in Patients with Liver Failure and Cirrhosis

Objective: The aim of this study was to estimate the incidence and inpatient outcomes of liver failure and cirrhosis (LFC) admissions with invasive aspergillosis (IA) in the United States. Methods: This retrospective cohort study utilized the 2016–2020 National Inpatient Sample (NIS) database to ana...

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Main Authors: Aditya Sharma, Bashar Mohamad, Ayman O. Soubani
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Journal of Fungi
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Online Access:https://www.mdpi.com/2309-608X/11/5/334
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author Aditya Sharma
Bashar Mohamad
Ayman O. Soubani
author_facet Aditya Sharma
Bashar Mohamad
Ayman O. Soubani
author_sort Aditya Sharma
collection DOAJ
description Objective: The aim of this study was to estimate the incidence and inpatient outcomes of liver failure and cirrhosis (LFC) admissions with invasive aspergillosis (IA) in the United States. Methods: This retrospective cohort study utilized the 2016–2020 National Inpatient Sample (NIS) database to analyze outcomes of IA in LFC admissions. Baseline variables, including demographics, comorbidities, and complications, were identified using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes, and liver transplant admissions were excluded. Outcomes were compared between LFC admissions with and without IA. Results: During the study period, 9515 (0.36%) LFC admissions were associated with IA. This cohort experienced significantly higher rates of complications, including acute kidney injury (AKI) (73.36% vs. 42.96%; <i>p</i> < 0.001) and acute respiratory failure (ARF) (65.74% vs. 24.85%; <i>p</i> < 0.001). IA admissions required invasive mechanical ventilation (IMV) more frequently (58.17% vs. 18.78%; <i>p</i> < 0.001). All-cause inpatient mortality was significantly higher in the aspergillosis group (43.40% vs. 15.75%; <i>p</i> < 0.001). IA admissions had longer lengths of stay (LOS), with 38.89% exceeding 21 days compared to 6.20% (<i>p</i> < 0.001), and a mean LOS more than three times longer (22.9 vs. 7.5 days; <i>p</i> < 0.001). The IA group incurred over four times higher hospital charges (USD 459,414.9 vs. USD 104,389.4; <i>p</i> < 0.001) and hospitalization costs (USD 108,030.6 vs. USD 24,272.1; <i>p</i> < 0.001) compared to the LFC without aspergillosis group. Interpretation: LFC admissions with IA experienced poorer outcomes, longer hospital stays, and significantly higher healthcare costs, underscoring the need for targeted interventions in this high-risk, nonclassical population.
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spelling doaj-art-132adde8eb12490aaa2d49e10fff46952025-08-20T03:47:54ZengMDPI AGJournal of Fungi2309-608X2025-04-0111533410.3390/jof11050334Epidemiology and Inpatient Outcomes of Invasive Aspergillosis in Patients with Liver Failure and CirrhosisAditya Sharma0Bashar Mohamad1Ayman O. Soubani2Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI 48201, USADivision of Gastroenterology, Wayne State University School of Medicine, Detroit, MI 48201, USADivision of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, MI 48201, USAObjective: The aim of this study was to estimate the incidence and inpatient outcomes of liver failure and cirrhosis (LFC) admissions with invasive aspergillosis (IA) in the United States. Methods: This retrospective cohort study utilized the 2016–2020 National Inpatient Sample (NIS) database to analyze outcomes of IA in LFC admissions. Baseline variables, including demographics, comorbidities, and complications, were identified using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes, and liver transplant admissions were excluded. Outcomes were compared between LFC admissions with and without IA. Results: During the study period, 9515 (0.36%) LFC admissions were associated with IA. This cohort experienced significantly higher rates of complications, including acute kidney injury (AKI) (73.36% vs. 42.96%; <i>p</i> < 0.001) and acute respiratory failure (ARF) (65.74% vs. 24.85%; <i>p</i> < 0.001). IA admissions required invasive mechanical ventilation (IMV) more frequently (58.17% vs. 18.78%; <i>p</i> < 0.001). All-cause inpatient mortality was significantly higher in the aspergillosis group (43.40% vs. 15.75%; <i>p</i> < 0.001). IA admissions had longer lengths of stay (LOS), with 38.89% exceeding 21 days compared to 6.20% (<i>p</i> < 0.001), and a mean LOS more than three times longer (22.9 vs. 7.5 days; <i>p</i> < 0.001). The IA group incurred over four times higher hospital charges (USD 459,414.9 vs. USD 104,389.4; <i>p</i> < 0.001) and hospitalization costs (USD 108,030.6 vs. USD 24,272.1; <i>p</i> < 0.001) compared to the LFC without aspergillosis group. Interpretation: LFC admissions with IA experienced poorer outcomes, longer hospital stays, and significantly higher healthcare costs, underscoring the need for targeted interventions in this high-risk, nonclassical population.https://www.mdpi.com/2309-608X/11/5/334invasive aspergillosisliver failurecirrhosisfungal infectioninvasive mechanical ventilation
spellingShingle Aditya Sharma
Bashar Mohamad
Ayman O. Soubani
Epidemiology and Inpatient Outcomes of Invasive Aspergillosis in Patients with Liver Failure and Cirrhosis
Journal of Fungi
invasive aspergillosis
liver failure
cirrhosis
fungal infection
invasive mechanical ventilation
title Epidemiology and Inpatient Outcomes of Invasive Aspergillosis in Patients with Liver Failure and Cirrhosis
title_full Epidemiology and Inpatient Outcomes of Invasive Aspergillosis in Patients with Liver Failure and Cirrhosis
title_fullStr Epidemiology and Inpatient Outcomes of Invasive Aspergillosis in Patients with Liver Failure and Cirrhosis
title_full_unstemmed Epidemiology and Inpatient Outcomes of Invasive Aspergillosis in Patients with Liver Failure and Cirrhosis
title_short Epidemiology and Inpatient Outcomes of Invasive Aspergillosis in Patients with Liver Failure and Cirrhosis
title_sort epidemiology and inpatient outcomes of invasive aspergillosis in patients with liver failure and cirrhosis
topic invasive aspergillosis
liver failure
cirrhosis
fungal infection
invasive mechanical ventilation
url https://www.mdpi.com/2309-608X/11/5/334
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AT aymanosoubani epidemiologyandinpatientoutcomesofinvasiveaspergillosisinpatientswithliverfailureandcirrhosis