OBJECTIVES: To identify prognostic factors of paediatric acute invasive fungal sinusitis (AIFS) patients.
DESIGN: Weighted cross-sectional analysis over 13-year period (2006-2019).
SETTING: Public national hospitalisation database.
PARTICIPANTS: Immunocompromised paediatric (age���<���21���years) patients with sinonasal fungal infection who underwent sinonasal surgical treatment.
MAIN OUTCOME MEASURES: Clinical characteristics (e.g., medical comorbidities, fungal species, age), mortality rate.
STATISTICAL ANALYSIS: To compare mortality rates, the Fisher's exact test was used for individual conditions, each fungal species, and hospital treatment setting. The sample's median age (12���years) divided patients into younger and older groups. For two-sided tests, a p value of <���0.05 was considered significant. A Bonferroni correction was applied to evaluate fungal species and mortality, where a p value <���0.0167 was considered significant.
RESULTS: A weighted total of 408 surgically treated AIFS patients were identified (median age 12���years). The most common immunocompromised comorbidities were neoplasms (75.7%) and hematologic disorders (71.2%). The most common fungal species were "other unspecified mycoses" as defined by ICD codes (53.8%) then mucormycoses (35%). The overall mortality rate was 16.1%. The only immunocompromised comorbidity associated with increased mortality was immunodeficiency disorders (25.3%; p���=���0.023). Demographics associated with increased mortality were being male (12.3% vs. 3.9%; p���=���0.004), but not older age (56.1% vs. 43.9%; p���=���0.588). Patients with aspergillosis infections had increased mortality (26.2%; p���=���0.003), but not other fungal species.
CONCLUSION: In the largest national sample of paediatric AIFS patients, the overall mortality rate was 16.1%. Negative prognostic indicators included male sex, immunodeficiency disorder, and aspergillosis infections.
