Arora-Nagarkar Prognostic Classification for Rhinocerebral Mucormycosis: A Novel Prognostic Classification System.

A Retroprospective observational study was conducted on Covid-19-associated mucormycosis (CAM) patients who underwent surgery at our institute. A total of 175 patients who met the inclusion and exclusion criteria were included in our study The study aimed to correlate the Overall survival and disease-specific survival rates with sites of involvement in patients with Covid Associated Mucormycosis and develop a novel prognostic classification of Mucormycosis. At the end of 24 months, the overall survival rate was 73.1% which can be attributed to the early diagnosis, timely & aggressive intervention, and multidisciplinary management. The Disease-Specific Survival rates were 90.16% (55alive/61total) for Sinonasal Mucormycosis, 87% (41/47) for Rhinomaxillary Mucormycosis, 64.7% (22/34) for Rhinoorbital Mucormycosis and 45.45% (10/22) for Rhinocerebral Mucormycosis. A statistically significant difference was seen between the disease severity and outcome. a novel staging system was developed with a focus on long-term patient outcomes. ANPCRM tapers patients' expectations and provides an ordinal measure of treatment outcome. It allows triaging of patients and better allocation of resources based on the final outcome which is the chances of survival of the patients.