Patterns of presentation and survival of HIV‐infected patients admitted to a tertiary‐level intensive care unit
Objectives Compared to other countires internationally, South Africa has the largest number of people living with HIV. There are limited data in developing countries on the outcomes of HIV‐infected patients in the intensive care unit (ICU). The objectives of this study were to describe the pattern o...
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| Veröffentlicht in: | HIV medicine 2020-05, Vol.21 (5), p.334-341 |
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| container_title | HIV medicine |
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| creator | Maphula, RW Laher, AE Richards, GA |
| description | Objectives
Compared to other countires internationally, South Africa has the largest number of people living with HIV. There are limited data in developing countries on the outcomes of HIV‐infected patients in the intensive care unit (ICU). The objectives of this study were to describe the pattern of presentation of these patients and to determine factors that may influence survival to ICU discharge.
Methods
The medical charts of 204 consecutive HIV‐infected individuals who were admitted to the Charlotte Maxeke Johannesburg Academic Hospital adult general ICU during the calendar year 2017 were retrospectively reviewed. Relevant data were subjected to univariate and multivariate analysis.
Results
Two‐hundred and four (22.6%) out of a total of 903 patients who were admitted to the ICU were HIV positive. Sepsis‐related illnesses were the most common reason for ICU admission (n = 95; 46.6%), followed by post‐operative care (n = 69; 33.8%) and non‐sepsis‐related illnesses (n = 40; 19.6%). The median length of stay in the ICU was 5 (interquartile range 2–9) days. ICU mortality was 33.3% (n = 68). On univariate analysis, age (P = 0.039), length of stay in the ICU (P = 0.040), primary diagnostic category (P |
| doi_str_mv | 10.1111/hiv.12834 |
| format | Article |
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Compared to other countires internationally, South Africa has the largest number of people living with HIV. There are limited data in developing countries on the outcomes of HIV‐infected patients in the intensive care unit (ICU). The objectives of this study were to describe the pattern of presentation of these patients and to determine factors that may influence survival to ICU discharge.
Methods
The medical charts of 204 consecutive HIV‐infected individuals who were admitted to the Charlotte Maxeke Johannesburg Academic Hospital adult general ICU during the calendar year 2017 were retrospectively reviewed. Relevant data were subjected to univariate and multivariate analysis.
Results
Two‐hundred and four (22.6%) out of a total of 903 patients who were admitted to the ICU were HIV positive. Sepsis‐related illnesses were the most common reason for ICU admission (n = 95; 46.6%), followed by post‐operative care (n = 69; 33.8%) and non‐sepsis‐related illnesses (n = 40; 19.6%). The median length of stay in the ICU was 5 (interquartile range 2–9) days. ICU mortality was 33.3% (n = 68). On univariate analysis, age (P = 0.039), length of stay in the ICU (P = 0.040), primary diagnostic category (P < 0.05), sepsis acquired during the ICU stay (P = 0.012), inotrope/vasopressor administration (P < 0.001), mechanical ventilation (P < 0.001), haemodialysis (P = 0.001), CD4 cell count (P = 0.011), Acute Physiology and Chronic Health Assessment (APACHE) II score (P < 0.001) and Sequential Organ Failure Assessment (SOFA) score (P < 0.001) were significantly associated with mortality.
Conclusions
Age, diagnostic category, sepsis acquired during the ICU stay, inotrope/vasopressor administration, mechanical ventilation, haemodialysis, CD4 cell count, APACHE II score, SOFA score and length of ICU stay were associated with ICU mortality in HIV‐infected patients.</description><identifier>ISSN: 1464-2662</identifier><identifier>EISSN: 1468-1293</identifier><identifier>DOI: 10.1111/hiv.12834</identifier><identifier>PMID: 31860776</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>CD4 antigen ; CD4 cell count ; critical care ; Developing countries ; Diagnostic systems ; haemodialysis ; Hemodialysis ; HIV ; Human immunodeficiency virus ; Illnesses ; inotrope ; Intensive care ; intensive care unit ; LDCs ; Mechanical ventilation ; Mortality ; Multivariate analysis ; Patients ; Sepsis ; Survival ; Ventilation ; Ventilators</subject><ispartof>HIV medicine, 2020-05, Vol.21 (5), p.334-341</ispartof><rights>2019 British HIV Association</rights><rights>2019 British HIV Association.</rights><rights>HIV Medicine © 2020 British HIV Association</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3884-d1ec27858372d7a3c56d12c15a7c206778da898a5cf806d0d2aed403d331aca43</citedby><cites>FETCH-LOGICAL-c3884-d1ec27858372d7a3c56d12c15a7c206778da898a5cf806d0d2aed403d331aca43</cites><orcidid>0000-0002-3306-7389</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fhiv.12834$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fhiv.12834$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31860776$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maphula, RW</creatorcontrib><creatorcontrib>Laher, AE</creatorcontrib><creatorcontrib>Richards, GA</creatorcontrib><title>Patterns of presentation and survival of HIV‐infected patients admitted to a tertiary‐level intensive care unit</title><title>HIV medicine</title><addtitle>HIV Med</addtitle><description>Objectives
Compared to other countires internationally, South Africa has the largest number of people living with HIV. There are limited data in developing countries on the outcomes of HIV‐infected patients in the intensive care unit (ICU). The objectives of this study were to describe the pattern of presentation of these patients and to determine factors that may influence survival to ICU discharge.
Methods
The medical charts of 204 consecutive HIV‐infected individuals who were admitted to the Charlotte Maxeke Johannesburg Academic Hospital adult general ICU during the calendar year 2017 were retrospectively reviewed. Relevant data were subjected to univariate and multivariate analysis.
Results
Two‐hundred and four (22.6%) out of a total of 903 patients who were admitted to the ICU were HIV positive. Sepsis‐related illnesses were the most common reason for ICU admission (n = 95; 46.6%), followed by post‐operative care (n = 69; 33.8%) and non‐sepsis‐related illnesses (n = 40; 19.6%). The median length of stay in the ICU was 5 (interquartile range 2–9) days. ICU mortality was 33.3% (n = 68). On univariate analysis, age (P = 0.039), length of stay in the ICU (P = 0.040), primary diagnostic category (P < 0.05), sepsis acquired during the ICU stay (P = 0.012), inotrope/vasopressor administration (P < 0.001), mechanical ventilation (P < 0.001), haemodialysis (P = 0.001), CD4 cell count (P = 0.011), Acute Physiology and Chronic Health Assessment (APACHE) II score (P < 0.001) and Sequential Organ Failure Assessment (SOFA) score (P < 0.001) were significantly associated with mortality.
Conclusions
Age, diagnostic category, sepsis acquired during the ICU stay, inotrope/vasopressor administration, mechanical ventilation, haemodialysis, CD4 cell count, APACHE II score, SOFA score and length of ICU stay were associated with ICU mortality in HIV‐infected patients.</description><subject>CD4 antigen</subject><subject>CD4 cell count</subject><subject>critical care</subject><subject>Developing countries</subject><subject>Diagnostic systems</subject><subject>haemodialysis</subject><subject>Hemodialysis</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Illnesses</subject><subject>inotrope</subject><subject>Intensive care</subject><subject>intensive care unit</subject><subject>LDCs</subject><subject>Mechanical ventilation</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Patients</subject><subject>Sepsis</subject><subject>Survival</subject><subject>Ventilation</subject><subject>Ventilators</subject><issn>1464-2662</issn><issn>1468-1293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp10b1OHDEQB3ArAgVyocgLRJZokmLBH3u2t4xOAU5CggLSrgZ7VjHa815s7yI6HiHPyJPg4y4UkXBjy_7pr_EMIV84O-Flnf720wkXRtYfyCGvlam4aOTe67muhFLigHxK6Z4xrmXDPpIDyY1iWqtDkq4hZ4wh0aGj64gJQ4bsh0AhOJrGOPkJ-s3jxfLX89NfHzq0GR1dF1VsouBWPm9u8kCBlqzsIT4W2uOEPfUhY0h-QmohIh2Dz5_Jfgd9wqPdPiO3Zz9vFhfV5dX5cvHjsrLSmLpyHK3QZm6kFk6DtHPluLB8DtoKprQ2DkxjYG47w5RjTgC6mkknJQcLtZyRb9vcdRz-jJhyu_LJYt9DwGFMrZCi0VLVpSszcvwfvR_GGEp1RTWCi2JkUd-3ysYhpYhdu45-VX7bctZuJtGWSbSvkyj26y5xvFuhe5P_Wl_A6RY8-B4f309qS-O3kS-QzpUY</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Maphula, RW</creator><creator>Laher, AE</creator><creator>Richards, GA</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3306-7389</orcidid></search><sort><creationdate>202005</creationdate><title>Patterns of presentation and survival of HIV‐infected patients admitted to a tertiary‐level intensive care unit</title><author>Maphula, RW ; Laher, AE ; Richards, GA</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3884-d1ec27858372d7a3c56d12c15a7c206778da898a5cf806d0d2aed403d331aca43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>CD4 antigen</topic><topic>CD4 cell count</topic><topic>critical care</topic><topic>Developing countries</topic><topic>Diagnostic systems</topic><topic>haemodialysis</topic><topic>Hemodialysis</topic><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>Illnesses</topic><topic>inotrope</topic><topic>Intensive care</topic><topic>intensive care unit</topic><topic>LDCs</topic><topic>Mechanical ventilation</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Patients</topic><topic>Sepsis</topic><topic>Survival</topic><topic>Ventilation</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maphula, RW</creatorcontrib><creatorcontrib>Laher, AE</creatorcontrib><creatorcontrib>Richards, GA</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>HIV medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maphula, RW</au><au>Laher, AE</au><au>Richards, GA</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patterns of presentation and survival of HIV‐infected patients admitted to a tertiary‐level intensive care unit</atitle><jtitle>HIV medicine</jtitle><addtitle>HIV Med</addtitle><date>2020-05</date><risdate>2020</risdate><volume>21</volume><issue>5</issue><spage>334</spage><epage>341</epage><pages>334-341</pages><issn>1464-2662</issn><eissn>1468-1293</eissn><abstract>Objectives
Compared to other countires internationally, South Africa has the largest number of people living with HIV. There are limited data in developing countries on the outcomes of HIV‐infected patients in the intensive care unit (ICU). The objectives of this study were to describe the pattern of presentation of these patients and to determine factors that may influence survival to ICU discharge.
Methods
The medical charts of 204 consecutive HIV‐infected individuals who were admitted to the Charlotte Maxeke Johannesburg Academic Hospital adult general ICU during the calendar year 2017 were retrospectively reviewed. Relevant data were subjected to univariate and multivariate analysis.
Results
Two‐hundred and four (22.6%) out of a total of 903 patients who were admitted to the ICU were HIV positive. Sepsis‐related illnesses were the most common reason for ICU admission (n = 95; 46.6%), followed by post‐operative care (n = 69; 33.8%) and non‐sepsis‐related illnesses (n = 40; 19.6%). The median length of stay in the ICU was 5 (interquartile range 2–9) days. ICU mortality was 33.3% (n = 68). On univariate analysis, age (P = 0.039), length of stay in the ICU (P = 0.040), primary diagnostic category (P < 0.05), sepsis acquired during the ICU stay (P = 0.012), inotrope/vasopressor administration (P < 0.001), mechanical ventilation (P < 0.001), haemodialysis (P = 0.001), CD4 cell count (P = 0.011), Acute Physiology and Chronic Health Assessment (APACHE) II score (P < 0.001) and Sequential Organ Failure Assessment (SOFA) score (P < 0.001) were significantly associated with mortality.
Conclusions
Age, diagnostic category, sepsis acquired during the ICU stay, inotrope/vasopressor administration, mechanical ventilation, haemodialysis, CD4 cell count, APACHE II score, SOFA score and length of ICU stay were associated with ICU mortality in HIV‐infected patients.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31860776</pmid><doi>10.1111/hiv.12834</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3306-7389</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | CD4 antigen CD4 cell count critical care Developing countries Diagnostic systems haemodialysis Hemodialysis HIV Human immunodeficiency virus Illnesses inotrope Intensive care intensive care unit LDCs Mechanical ventilation Mortality Multivariate analysis Patients Sepsis Survival Ventilation Ventilators |
| title | Patterns of presentation and survival of HIV‐infected patients admitted to a tertiary‐level intensive care unit |
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