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Longitudinal assessment (1995–2003) of hospitalizations of HIV‐infected patients within a geographical population in Canada
Author(s) -
Krentz HB,
Dean S,
Gill MJ
Publication year - 2006
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/j.1468-1293.2006.00408.x
Subject(s) - medicine , human immunodeficiency virus (hiv) , population , pediatrics , antiretroviral therapy , young adult , viral load , emergency medicine , immunology , environmental health
Objectives To determine the frequency of and reasons for hospitalization of adult HIV‐infected patients compared with the general population. Methods Length of stay, primary/secondary diagnoses and discharge status were reviewed for all HIV‐infected patients admitted to Calgary‐area hospitals between 1995 and 2003. Admissions were classified as HIV‐ or non‐HIV‐related using International Classification of Diseases, 9th and 10th revisions (ICD‐9/10) codes and confirmed by chart review. Summary comparative data on admissions for the general population were obtained from the regional administrative database. Results HIV‐infected adults were hospitalized more than twice as frequently, experienced longer stays (median length 5 vs 3 days, respectively) and had higher in‐hospital mortality rates (9.1 vs 1.3 per 100 admissions, respectively) than the general population ( P <0.01). Hospitalizations of HIV‐infected patients declined by 58% from 1995 to 2003. Patients newly diagnosed with HIV infection accounted for 15% of all HIV‐related hospitalizations. HIV‐related admissions for known HIV‐infected patients decreased from 12 per 100 patient‐years‐followed in 1995 to 3 per 100 patient‐years‐followed in 2003. Low CD4 counts, AIDS, and no current use of highly active antiretroviral therapy (HAART) were strongly correlated with hospitalizations ( P <0.01). Non‐HIV‐related hospitalizations for HIV‐infected patients increased by 42% and were associated with comorbidities (e.g. substance use and psychological disorders). Conclusion Despite the reduction in HIV‐related hospitalizations following the introduction of HAART, all‐cause hospitalization rates have increased and have started to erode this benefit.