Another layer of complexity is added by the role of Gram-positive bacterial co-infection, which was identified as an associated predictor with borderline significance in the multivariable model (p = 0.061) but consistent importance across all three algorithms.
Results The co-infection group exhibited substantially higher ICU mortality than the sole Aspergillus group, although the difference did not reach statistical significance (72.2% vs. 53.3%, p = 0.24).Kaplan–Meier analysis demonstrated that initiation of amphotericin B within <7 days of diagnosis or strong clinical suspicion was significantly associated with improved survival (log-rank p < 0.0001).
In terms of organ support, there was a notable trend toward increased utilization of extracorporeal membrane oxygenation (ECMO) in the mixed group (22.2% vs. 6.7%).