Factors associated with 90-day mortality in adults with cryptococcal meningoencephalitis across HIV, solid organ transplant, and non-HIV, non-transplant populations - Scorecard - MDSpire
Clinical Scorecard: Determinants of 90-Day Mortality in Adults with Cryptococcal Meningoencephalitis in HIV, Solid Organ Transplant, and Non-HIV, Non-Transplant Groups
At a Glance
Category
Detail
Condition
Cryptococcal Meningoencephalitis
Key Mechanisms
Invasive fungal infection with high mortality rates, particularly in NHNT populations.
Target Population
Adults aged ≥18 years with Cryptococcal Meningoencephalitis.
Care Setting
Clinical assessment of mortality determinants in diverse host groups.
Key Highlights
90-day mortality was highest in NHNT patients (23.1%), followed by SOT (19.4%) and HIV (12.4%).
Older age and White race were associated with increased mortality.
Neoplasms and hematologic malignancies were more prevalent among non-survivors.
Pre-index immunosuppressive medication exposure did not differ significantly between survivors and non-survivors.
NHNT status was associated with increased mortality relative to HIV.
Guideline-Based Recommendations
Diagnosis
Diagnosis based on ICD-10-CM codes and CSF cryptococcal antigen or DNA evidence.
Management
Treatment with amphotericin B during the index encounter.
Monitoring & Follow-up
Assess 90-day mortality as a key outcome measure.
Risks
Older age, White race, and presence of neoplasms or hematologic malignancies increase mortality risk.
Patient & Prescribing Data
Adults with Cryptococcal Meningoencephalitis treated with amphotericin B.
Pre-index exposure to immunosuppressive medications did not significantly differ between survivors and non-survivors.
Clinical Best Practices
Utilize comprehensive patient assessments to determine comorbidities and immunosuppressive medication exposures.
Monitor demographic factors such as age and race in relation to mortality outcomes.
Implement stratified analyses by host group to better understand mortality determinants.
