Risk Factors of Mortality in Older Patients With Candidemia

BACKGROUND/AIM: Candidemia is a life-threatening fungal infection associated with high mortality and significant morbidity, particularly among older adults. Few studies have addressed mortality in this population. This study aimed to identify the risk factors for mortality in older patients with candidemia. PATIENTS AND METHODS: We conducted a retrospective study to identify the risk factors for mortality in older patients with candidemia using the Medical Information Mart for Intensive Care-IV database. The clinical characteristics and risk factors for mortality in patients younger or older than 65 years of age were determined. We also evaluated the effects of early antifungal therapy on outcomes in these patients. RESULTS: Among patients with candidemia, advanced age, congestive heart failure, cardiac arrhythmia, smoking habits, leukocytosis, and thrombocytopenia were significantly associated with in-hospital mortality. The early administration of antifungal therapy was related to improved survival in all age groups. Among older individuals who died during hospitalization, a higher prevalence of congestive heart failure, pulmonary vascular diseases, and smoking habit was observed. In contrast, the younger patients who died had a higher incidence of underlying metastatic cancer, coagulopathy, and cardiac arrhythmia. CONCLUSION: Older patients with candidemia had higher in-hospital mortality rates than those of younger patients. Thrombocytopenia was found to be an independent risk factor, and early fungal therapy was associated with lower in-hospital mortality. Early identification of patients with candidemia and appropriate antifungal therapy are important for its treatment.