Factors Associated with Length of Hospital Stay among HIV Positive and HIV Negative Patients with Tuberculosis in Brazil

Gonçalves, Maria Jacirema Ferreira; Ferreira, Alaidistânia Aparecida

doi:10.1371/journal.pone.0060487

Cited by 8 publications

(7 citation statements)

References 12 publications

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“… 17 In addition, tuberculosis is also associated with longer LOS both among the general and the HIV-infected population. 18 , 19 In our study cohort, tuberculosis accounted for 43% of all AIDS related hospitalizations and yielded an inhospital mortality of 10.9% (data not shown). Additionally, LOS of tuberculosis related hospitalization was significantly longer than non-tuberculosis hospitalizations (median of 18 days vs. 12 days, respectively, p < 0.001, data not shown).…”

Section: Discussionmentioning

confidence: 63%

Hospitalization rates, length of stay and in-hospital mortality in a cohort of HIV infected patients from Rio de Janeiro, Brazil

Coelho

Ribeiro

Veloso

et al. 2017

The Brazilian Journal of Infectious Diseases

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In this study, we evaluated trends in hospitalization rates, length of stay and in-hospital mortality in a cohort of HIV-infected patients in Rio de Janeiro, Brazil, from 2007 through 2013. Among the 3991 included patients, 1861 hospitalizations occurred (hospitalization rate of 10.44/100 person-years, 95% confidence interval 9.98–10.93/100 person-years). Hospitalization rates decreased annually (per year incidence rate ratio 0.92, 95% confidence interval 0.89–0.95) as well as length of stay (median of 15 days in 2007 vs. 11 days in 2013, p-value for trend < 0.001), and in-hospital mortality (13.4% in 2007 to 8.1% in 2013, p-value for trend = 0.053). Our results show that, in a middle-income setting, hospitalization rates are decreasing over time and non-AIDS hospitalizations are currently more frequent than those related to AIDS. Notwithstanding, compared with high-income settings, our patients had longer length of stay and higher in-hospital mortality. Further studies addressing these outcomes are needed to provide information that may guide protocols and interventions to further reduce health-care costs and in-hospital mortality.

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Section: Discussionmentioning

confidence: 63%

Hospitalization rates, length of stay and in-hospital mortality in a cohort of HIV infected patients from Rio de Janeiro, Brazil

Coelho

Ribeiro

Veloso

et al. 2017

The Brazilian Journal of Infectious Diseases

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“…This finding may indicate that comorbidities contributed to a more severe condition that required hospitalization [ 26 ]. In the previous research, patients with TB and comorbidities, particularly renal and liver diseases, diabetes mellitus, HIV, or cancer, were more likely to be hospitalized and have longer inpatient treatment [ 8 , 26 , 27 , 28 ]. Similarly, we found that patients with UGTB and hepatitis B were more likely to stay longer in the hospital.…”

Section: Discussionmentioning

confidence: 99%

“…Repeated hospital admissions were not common in our study population, which is consistent with previous research. Patients usually start TB treatment in-hospital and initial hospitalization contributes the most to the total length of stay during treatment [ 8 , 28 ]. Research in the United States and Canada, countries that prioritize reduction of hospital admissions, showed similar proportions of patients with TB with multiple hospitalization episodes during treatment (7 and 8%, respectively) [ 8 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

Hospitalizations and Treatment Outcomes in Patients with Urogenital Tuberculosis in Tashkent, Uzbekistan, 2016–2018

Ismatov

Sereda

Sahakyan³

et al. 2021

IJERPH

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Despite the global shift to ambulatory tuberculosis (TB) care, hospitalizations remain common in Uzbekistan. This study examined the duration and determinants of hospitalizations among adult patients (≥18 years) with urogenital TB (UGTB) treated with first-line anti-TB drugs during 2016–2018 in Tashkent, Uzbekistan. This was a cohort study based on the analysis of health records. Of 142 included patients, 77 (54%) were males, the mean (±standard deviation) age was 40 ± 16 years, and 68 (48%) were laboratory-confirmed. A total of 136 (96%) patients were hospitalized during the intensive phase, and 12 (8%) had hospital admissions during the continuation phase of treatment. The median length of stay (LOS) during treatment was 56 days (Interquartile range: 56–58 days). LOS was associated with history of migration (adjusted incidence rate ratio (aIRR): 0.46, 95% confidence interval (CI): 0.32–0.69, p < 0.001); UGTB-related surgery (aIRR: 1.18, 95% CI: 1.01–1.38, p = 0.045); and hepatitis B comorbidity (aIRR: 3.18, 95% CI: 1.98–5.39, p < 0.001). The treatment success was 94% and it was not associated with the LOS. Hospitalization was almost universal among patients with UGTB in Uzbekistan. Future research should focus on finding out what proportion of hospitalizations were not clinically justified and could have been avoided.

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“…Additionally, a study that retrospectively evaluated the effect of various factors on hospital LOS in Louisiana, USA between 1998 and 2003, reported that gender and age were non-significant predictors, while the number of comorbid conditions and inpatient procedures and the presence of an AIDS defining diagnosis were significant independent predictors [11]. Another study conducted in Brazil, reported that low income was associated with prolonged LOS among HIV-positive patients with tuberculosis [12]. In comparison to the findings of some of the above studies, tuberculosis, multiple organ involvement (�3 organ systems) and in-hospital mortality were associated with a longer LOS on univariate analysis, while there were no significant differences with regards to age, gender, low CD 4 cell count (<100 cell/mm 3 ), use of ART and Pneumocystis jirovecii pneumonia.…”

Section: Plos Onementioning

confidence: 99%

“…There is a paucity of published data pertaining to factors that predict the length of hospitalization in HIV-positive patients presenting to the ED [11,12]. In addition to guiding clinical management, the identification of these factors may assist clinicians with triage and the appropriate channeling of resources, particularly in resource limited environments.…”

Section: Introductionmentioning

confidence: 99%

Predictors of prolonged hospital stay in HIV-positive patients presenting to the emergency department

et al. 2021

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Background Prolonged hospitalization places a significant burden on healthcare resources. Compared to the general population, hospital length of stay (LOS) is generally longer in HIV-positive patients. We identified predictors of prolonged hospital length of stay (LOS) in HIV-positive patients presenting to an emergency department (ED). Methods In this cross-sectional study, HIV-positive patients presenting to the Charlotte Maxeke Johannesburg Academic Hospital adult ED were prospectively enrolled between 07 July 2017 and 18 October 2018. Data was subjected to univariate and multivariate logistic regression to determine parameters associated with a higher likelihood of prolonged hospital LOS, defined as ≥7 days. Results Among the 1224 participants that were enrolled, the median (IQR) LOS was 4.6 (2.6–8.2) days, while the mean (SD) LOS was 6.9 (8.2) days. On multivariate analysis of the data, hemoglobin <11 g/dL (OR 1.37, p = 0.032), Glasgow coma scale (GCS) <15 (OR 1.80, p = 0.001), creatinine >120 μmol/L (OR 1.85, p = 0.000), cryptococcal meningitis (OR 2.45, p = 0.015) and bacterial meningitis (OR 4.83, p = 0.002) were significantly associated with a higher likelihood of LOS ≥7 days, while bacterial pneumonia (OR 0.35, p = 0.000) and acute gastroenteritis (OR 0.40, p = 0.025) were significantly associated with a lower likelihood of LOS ≥7 days. Conclusion Various clinical and laboratory parameters are useful in predicting prolonged hospitalization among HIV-positive patients presenting to the ED. These parameters may be useful in guiding clinical decision making and directing the allocation of resources.

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Factors Associated with Length of Hospital Stay among HIV Positive and HIV Negative Patients with Tuberculosis in Brazil

Cited by 8 publications

References 12 publications

Hospitalization rates, length of stay and in-hospital mortality in a cohort of HIV infected patients from Rio de Janeiro, Brazil

Hospitalization rates, length of stay and in-hospital mortality in a cohort of HIV infected patients from Rio de Janeiro, Brazil

Hospitalizations and Treatment Outcomes in Patients with Urogenital Tuberculosis in Tashkent, Uzbekistan, 2016–2018

Predictors of prolonged hospital stay in HIV-positive patients presenting to the emergency department

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