Risk Of Severe Hepatic Injury In Patients With Invasive Candidiasis Treated With Echinocandins

• Invasive Candidiasis
• Candidemia

• Cases
  
  Potential cases were defined as patients with a diagnosis of severe hepatic injury identified in the acute-care inpatient cohort using ICD-9 codes associated with the case definition of severe liver injury. Case status was validated by a Consultant Gastroenterologist blinded to study drug exposure via medical record review using an apriori algorithm. Only validated cases were included in the analysis (N=69)
  Intervention: Other: Does not apply
• Controls
  
  Controls were defined as patients without a diagnosis of severe hepatic injury (i.e. with no ICD-9 codes associated with the case definition of severe liver injury) selected at random from the same acute-care inpatient cohort as cases (N=467)
  Intervention: Other: Does not apply

Inclusion Criteria:

• Acute-care inpatients;
• Aged 18 years or older;
• At least one dose of echinocandin therapy during the hospitalization;
• Primary or secondary ICD-9 discharge diagnosis of invasive candidiasis / candidemia.

Exclusion Criteria:

• < 18 years of age;
• No recorded echinocandin therapy during hospitalization;
• Acetaminophen hepatotoxicity;
• Pre-existing autoimmune hepatitis;
• Autoimmune/metabolic liver disease;
• Primary biliary cirrhosis;
• Primary sclerosing cholangitis and orthotopic liver transplantation.