Predicting risk of mortality of chronic pulmonary aspergillosis

<b>Background:</b> Chronic pulmonary aspergillosis (CPA) is a chronic infectious disease that occurs frequently in patients with underlying pulmonary disease. The prognosis for CPA is considered poor, and according to previous reports, 5-year survival rates are around 50%. <b>Aims and Objectives:</b> We aimed to investigate clinical characteristics and prognostic factors of patients with CPA. We retrospectively analysed 259 patients with CPA who were diagnosed between 2011 and 2018 in our hospital. <b>Results:</b> Among these patients, 188 (72.6%) were men, and 169 (65.3%) were ever smokers. Median age at diagnosis was 69 years, and median body mass index was 17.9 kg/m². The main underlying pulmonary diseases in the patients included previous pulmonary tuberculosis in 68 (26.3%), nontuberculous mycobacteriosis in 62 (23.9%), emphysema in 53 (20.5%), interstitial lung diseases (ILD) in 27 (29.3%), and active pulmonary tuberculosis in 25 (9.7%). During the follow-up period, 94 (36.3%) patients died. A multivariable Cox proportional hazard model showed higher age (≥70 years) and lower albumin (&lt;3.5 g/dL), higher inflammation levels (CRP ≥3 mg/dL), and presence of ILD to be the prognostic factors for mortality. On the basis of four independent factors, we established a simple 0-to-4 point scoring system for predicting the mortality of patients with CPA. When comparing each point, we found significant differences between the Kaplan-Meier curves of mortality. <b>Conclusions:</b> We identified prognostic factors and established a simple scoring system for predicting the prognosis of CPA.