The impact of opportunistic infections on clinical outcome and healthcare resource uses for adult T cell leukaemia

Toshiki Maeda, Akira Babazono, Takumi Nishi, Midori Yasui, Shinya Matsuda, Kiyohide Fushimi, Kenji Fujimori

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

We examined the impact of opportunistic infections on in-hospital mortality, hospital length of stay (LOS), and the total cost (TC) among adult T-cell leukaemia (ATL) patients. In this retrospective cohort study, we identified 3712 patients with ATL using national hospital administrative data. Analysed opportunistic infections included Aspergillus spp., Candida spp., cytomegalovirus (CMV), herpes simplex virus (HSV), pneumocystis pneumonia (PCP), tuberculosis, varicella zoster virus (VZV), Cryptococcus spp., nontuberculous mycobacteria, and Strongyloides spp. Multilevel logistic regression analysis for in-hospital mortality and a multilevel linear regression analysis for LOS and TC were employed to determine the impact of opportunistic infections on clinical outcomes and healthcare resources. We found ATL patients infected with CMV had significantly higher in-hospital mortality (adjusted odds ratio (AOR) 2.29 [1.50-3.49] p < 0.001), longer LOS (coefficient (B): 0.13 [0.06-0.20] p < 0.001) and higher TC (B: 0.25 [0.17-0.32] p < 0.001) than those without CMV. Those with CAN and PCP were associated with a lower in-hospital mortality rate (AOR 0.72 [0.53-0.98] p = 0.035 and 0.54[0.41-0.73] p < 0.001, respectively) than their infections. VZV was associated with longer LOS (B: 0.13 [0.06-0.19] p < 0.001), while aspergillosis, HSV, or VZV infections were associated with higher TC (B: 0.16 [0.07-0.24] p < 0.001, 0.12 [0.02-0.23] p = 0.025, and 0.17 [0.10-0.24] p < 0.001, respectively). Our findings reveal that CMV infection is a major determinant of poor prognosis in patients affected by ATL.

Original languageEnglish
Article numbere0135042
JournalPloS one
Volume10
Issue number8
DOIs
Publication statusPublished - Aug 14 2015

Fingerprint

Adult T Cell Leukemia Lymphoma
T-cells
Opportunistic Infections
leukemia
health services
Length of Stay
Viruses
Hospital Mortality
T-lymphocytes
Human herpesvirus 3
Human Herpesvirus 3
Delivery of Health Care
Cytomegalovirus
Costs and Cost Analysis
Pneumocystis Pneumonia
infection
Pneumocystis
herpes simplex
Simplexvirus
Regression analysis

All Science Journal Classification (ASJC) codes

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

The impact of opportunistic infections on clinical outcome and healthcare resource uses for adult T cell leukaemia. / Maeda, Toshiki; Babazono, Akira; Nishi, Takumi; Yasui, Midori; Matsuda, Shinya; Fushimi, Kiyohide; Fujimori, Kenji.

In: PloS one, Vol. 10, No. 8, e0135042, 14.08.2015.

Research output: Contribution to journalArticle

Maeda, Toshiki ; Babazono, Akira ; Nishi, Takumi ; Yasui, Midori ; Matsuda, Shinya ; Fushimi, Kiyohide ; Fujimori, Kenji. / The impact of opportunistic infections on clinical outcome and healthcare resource uses for adult T cell leukaemia. In: PloS one. 2015 ; Vol. 10, No. 8.
@article{eecffbc1f887456ebaf25914d65b4578,
title = "The impact of opportunistic infections on clinical outcome and healthcare resource uses for adult T cell leukaemia",
abstract = "We examined the impact of opportunistic infections on in-hospital mortality, hospital length of stay (LOS), and the total cost (TC) among adult T-cell leukaemia (ATL) patients. In this retrospective cohort study, we identified 3712 patients with ATL using national hospital administrative data. Analysed opportunistic infections included Aspergillus spp., Candida spp., cytomegalovirus (CMV), herpes simplex virus (HSV), pneumocystis pneumonia (PCP), tuberculosis, varicella zoster virus (VZV), Cryptococcus spp., nontuberculous mycobacteria, and Strongyloides spp. Multilevel logistic regression analysis for in-hospital mortality and a multilevel linear regression analysis for LOS and TC were employed to determine the impact of opportunistic infections on clinical outcomes and healthcare resources. We found ATL patients infected with CMV had significantly higher in-hospital mortality (adjusted odds ratio (AOR) 2.29 [1.50-3.49] p < 0.001), longer LOS (coefficient (B): 0.13 [0.06-0.20] p < 0.001) and higher TC (B: 0.25 [0.17-0.32] p < 0.001) than those without CMV. Those with CAN and PCP were associated with a lower in-hospital mortality rate (AOR 0.72 [0.53-0.98] p = 0.035 and 0.54[0.41-0.73] p < 0.001, respectively) than their infections. VZV was associated with longer LOS (B: 0.13 [0.06-0.19] p < 0.001), while aspergillosis, HSV, or VZV infections were associated with higher TC (B: 0.16 [0.07-0.24] p < 0.001, 0.12 [0.02-0.23] p = 0.025, and 0.17 [0.10-0.24] p < 0.001, respectively). Our findings reveal that CMV infection is a major determinant of poor prognosis in patients affected by ATL.",
author = "Toshiki Maeda and Akira Babazono and Takumi Nishi and Midori Yasui and Shinya Matsuda and Kiyohide Fushimi and Kenji Fujimori",
year = "2015",
month = "8",
day = "14",
doi = "10.1371/journal.pone.0135042",
language = "English",
volume = "10",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "8",

}

TY - JOUR

T1 - The impact of opportunistic infections on clinical outcome and healthcare resource uses for adult T cell leukaemia

AU - Maeda, Toshiki

AU - Babazono, Akira

AU - Nishi, Takumi

AU - Yasui, Midori

AU - Matsuda, Shinya

AU - Fushimi, Kiyohide

AU - Fujimori, Kenji

PY - 2015/8/14

Y1 - 2015/8/14

N2 - We examined the impact of opportunistic infections on in-hospital mortality, hospital length of stay (LOS), and the total cost (TC) among adult T-cell leukaemia (ATL) patients. In this retrospective cohort study, we identified 3712 patients with ATL using national hospital administrative data. Analysed opportunistic infections included Aspergillus spp., Candida spp., cytomegalovirus (CMV), herpes simplex virus (HSV), pneumocystis pneumonia (PCP), tuberculosis, varicella zoster virus (VZV), Cryptococcus spp., nontuberculous mycobacteria, and Strongyloides spp. Multilevel logistic regression analysis for in-hospital mortality and a multilevel linear regression analysis for LOS and TC were employed to determine the impact of opportunistic infections on clinical outcomes and healthcare resources. We found ATL patients infected with CMV had significantly higher in-hospital mortality (adjusted odds ratio (AOR) 2.29 [1.50-3.49] p < 0.001), longer LOS (coefficient (B): 0.13 [0.06-0.20] p < 0.001) and higher TC (B: 0.25 [0.17-0.32] p < 0.001) than those without CMV. Those with CAN and PCP were associated with a lower in-hospital mortality rate (AOR 0.72 [0.53-0.98] p = 0.035 and 0.54[0.41-0.73] p < 0.001, respectively) than their infections. VZV was associated with longer LOS (B: 0.13 [0.06-0.19] p < 0.001), while aspergillosis, HSV, or VZV infections were associated with higher TC (B: 0.16 [0.07-0.24] p < 0.001, 0.12 [0.02-0.23] p = 0.025, and 0.17 [0.10-0.24] p < 0.001, respectively). Our findings reveal that CMV infection is a major determinant of poor prognosis in patients affected by ATL.

AB - We examined the impact of opportunistic infections on in-hospital mortality, hospital length of stay (LOS), and the total cost (TC) among adult T-cell leukaemia (ATL) patients. In this retrospective cohort study, we identified 3712 patients with ATL using national hospital administrative data. Analysed opportunistic infections included Aspergillus spp., Candida spp., cytomegalovirus (CMV), herpes simplex virus (HSV), pneumocystis pneumonia (PCP), tuberculosis, varicella zoster virus (VZV), Cryptococcus spp., nontuberculous mycobacteria, and Strongyloides spp. Multilevel logistic regression analysis for in-hospital mortality and a multilevel linear regression analysis for LOS and TC were employed to determine the impact of opportunistic infections on clinical outcomes and healthcare resources. We found ATL patients infected with CMV had significantly higher in-hospital mortality (adjusted odds ratio (AOR) 2.29 [1.50-3.49] p < 0.001), longer LOS (coefficient (B): 0.13 [0.06-0.20] p < 0.001) and higher TC (B: 0.25 [0.17-0.32] p < 0.001) than those without CMV. Those with CAN and PCP were associated with a lower in-hospital mortality rate (AOR 0.72 [0.53-0.98] p = 0.035 and 0.54[0.41-0.73] p < 0.001, respectively) than their infections. VZV was associated with longer LOS (B: 0.13 [0.06-0.19] p < 0.001), while aspergillosis, HSV, or VZV infections were associated with higher TC (B: 0.16 [0.07-0.24] p < 0.001, 0.12 [0.02-0.23] p = 0.025, and 0.17 [0.10-0.24] p < 0.001, respectively). Our findings reveal that CMV infection is a major determinant of poor prognosis in patients affected by ATL.

UR - http://www.scopus.com/inward/record.url?scp=84942896733&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84942896733&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0135042

DO - 10.1371/journal.pone.0135042

M3 - Article

C2 - 26274925

AN - SCOPUS:84942896733

VL - 10

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 8

M1 - e0135042

ER -