دورية أكاديمية
Short‐ and medium‐term prognosis of HIV‐infected patients receiving intensive care: a Brazilian multicentre prospective cohort study.
| العنوان: | Short‐ and medium‐term prognosis of HIV‐infected patients receiving intensive care: a Brazilian multicentre prospective cohort study. |
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| المؤلفون: | Andrade, HB, da Silva, IRF, Ramos, GV, Medeiros, DM, Ho, YL, Carvalho, FB, Bozza, FA, Japiassú, AM |
| المصدر: | HIV Medicine; Nov2020, Vol. 21 Issue 10, p650-658, 9p |
| مصطلحات موضوعية: | HIV infection prognosis, CRITICAL care medicine, CRITICALLY ill, HIV-positive persons, HOSPITAL admission & discharge, INTENSIVE care units, LONGITUDINAL method, MEDICAL cooperation, MEDICAL records, MULTIVARIATE analysis, PATIENTS, RESEARCH, RESPIRATORY insufficiency, SEPSIS, SEVERITY of illness index, HOSPITAL mortality, GLASGOW Coma Scale, ACQUISITION of data methodology |
| مصطلحات جغرافية: | BRAZIL |
| مستخلص: | Objectives: The characteristics of critically ill HIV‐positive patients and the causes of their admission to intensive care units (ICUs) are only known through retrospective and unicentric studies. This study aims to fill this knowledge gap. Methods: This is a prospective, multicentre cohort study of short‐ and medium‐term prognostic factors. The setting consisted of ICUs of three tertiary referral hospitals from the three largest metropolitan areas in Brazil in the period January 2014 to November 2015. In all, 161 HIV patients over 18 years old were included. Results: The clinical data of the outcomes (ICU mortality, hospital mortality and 90‐day survival) were extracted from medical records using the REDCap®️ web‐based form and analysed with the MedCalc®️ application. Median age was 41.7 [interquartile range (IQR): 34–50] years, the Simplified Acute Physiologic Score 3 (SAPS 3) was 64 (IQR: 56–74), and the Sequential Organ Failure Assessment Score (SOFA) was 6 (IQR: 4–9) points. The main causes of admission were sepsis (54.5%) and acute respiratory failure (13.7%). ICU and hospital mortality rates were 32.3% and 40.4%, respectively. In a multivariate analysis, time until ICU admission ≥ 3 days (P = 0.0013), performance status (Eastern Cooperative Oncology Group score, P = 0.0344), coma (Glasgow Coma Scale ≤ 8 points, P = 0.0213) and sepsis (P = 0.0003) were associated with increased hospital mortality. Coma (P = 0.0002) and sepsis (P = 0.0008) were independently associated with 90‐day survival. Conclusions: Delayed ICU admission and the severity of critical illness determine the short‐ and medium‐term mortality rates of HIV‐infected patients admitted to the ICU, rather than factors associated with HIV infection. These results suggest that prognostic factors of HIV‐infected patients in the ICU are similar to those of non‐HIV‐infected populations. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: | Complementary Index |
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