Open AccessClinical outcome and predictors of survival in patients with pneumocystis jirovecii pneumonia – results of a tertiary referral centre
Author(s) -
Roembke Felicitas,
Heinzow Hauke Sebastian,
Gosseling Thomas,
Heinecke Achim,
Domagk Dirk,
Domschke Wolfram,
Meister Tobias
Publication year - 2014
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12042
Subject(s) - medicine , proportional hazards model , log rank test , survival analysis , pneumocystis jirovecii , pneumocystis pneumonia , pneumonia , univariate analysis , multivariate analysis
Abstract Background and Aims Pneumocystis jirovecii pneumonia also known as pneumocystis pneumonia ( PCP ) is an opportunistic respiratory infection in human immunodeficiency virus ( HIV ) patients that may also develop in non‐ HIV immunocompromised persons. The aim of our study was to evaluate mortality predictors of PCP patients in a tertiary referral centre. Methods Fifty‐one patients with symptomatic PCP were enrolled in the study. The patients had either HIV infection ( n = 21) or other immunosuppressive conditions ( n = 30). Baseline characteristics (e.g. age, sex and underlying disease) were retrieved. K aplan– M eier analysis was employed to calculate survival. Comparisons were made by log‐rank test. A multivariate analysis of factors influencing survival was carried out using the Cox regression model. Chi‐squared test and W ilcoxon– M ann– W hitney test was applied as appropriate. Results The median survival time for the HIV group was >120 months compared with 3 months for the non‐ HIV group ( P = 0.009). Three‐month survival probability was also significantly greater in the HIV group compared with the non‐ HIV group (90% vs 41%, P = 0.002). In univariate log‐rank test, intensive care unit ( ICU ) necessity, HIV negativity, age >50 years, haemoglobin <10g/dl, C ‐reactive protein >5 mg/dL and multiple comorbidities were significant negative predictors of survival. In the C ox regression model, ICU and HIV statuses turned out to be independent prognostic factors of survival. Conclusion PCP is a serious problem in non‐ HIV immunocompromised patients in whom survival outcomes are worse than those in HIV patients.