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Patterns of presentation and survival of HIV‐infected patients admitted to a tertiary‐level intensive care unit
Author(s) -
Maphula RW,
Laher AE,
Richards GA
Publication year - 2020
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12834
Subject(s) - medicine , interquartile range , sofa score , intensive care unit , univariate analysis , mechanical ventilation , sepsis , apache ii , saps ii , emergency medicine , multivariate analysis , pediatrics
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.