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

Coelho, Lara E.; Ribeiro, Sayonara Rocha; Veloso, Valdiléa G.; Grinsztejn, Beatriz; Luz, Paula M.

doi:10.1016/j.bjid.2016.10.007

Cited by 16 publications

(20 citation statements)

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“…This finding is in line with the study conducted in Spain, in which 53% of deaths were attributed to AIDS defining illnesses [23]. Similar study from Brazil reported that in-hospital mortality was almost two times higher in AIDS-related hospitalizations than in non-AIDS-related hospitalizations [24]. However, several studies from developed countries reported non-AIDS-related illnesses as being the most common cause of death [25–27].…”

Section: Discussionsupporting

confidence: 87%

Clinical outcome of admitted HIV/AIDS patients in Ethiopian tertiary care settings: A prospective cohort study

Negera

Mega

2019

PLoS ONE

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BackgroundAcquired ImmunoDeficiency Syndrome (AIDS) related illnesses are the leading cause of death in the developing world. However; there is limited evidence regarding the incidence of mortality among admitted HIV patients in Ethiopia.ObjectiveTo determine the incidence of mortality and its predictors among admitted HIV/AIDS patients in selected tertiary care hospitals in Ethiopia.MethodsA prospective cohort study involving 136 admitted HIV/AIDS patients from April 1 to August 31, 2018 was conducted in selected tertiary care hospitals in Ethiopia. Data were collected on socio-demographic, clinical characteristics, and drug related variables. Kaplan-Meier and Cox regression were used to compare survival experience of the patients and identify independent predictors of mortality. Hazard ratio was used as a measure of strength of association and p-value of <0.05 was considered to declare statistical significance.ResultsOf 136 patients, 80 (58.8%) were females. The overall in-hospital incidence of mortality was 2.83 per 1000 person-years. The incidences of mortality due to AIDS and non-AIDS related admissions were 6.1 [3.95, 8.67] and 5.3 [3.35, 8.23] per 1000 person-years respectively. The mean ± SD survival times among patients with AIDS and non-AIDS related illnesses were 32 ± 3.1 and 34 ± 3.3 days respectively (log rank p = 0.599). Being on non-invasive ventilation (AHR: 2.99, 95%CI; [1.24, 7.28]; p = 0.015) and having baseline body mass index (BMI) of less than 18.5 (AHR: 2.6, 95%CI; [1.03, 6.45]; p = 0.04) were independent predictors of mortality.ConclusionThe study found high incidence of in-hospital mortality among admitted HIV/AIDS patients in Ethiopian tertiary care hospitals. Being on non-invasive ventilation and body mass index (BMI) of less than 18.5 were found to be independent predictors of mortality.

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Section: Discussionsupporting

confidence: 87%

Clinical outcome of admitted HIV/AIDS patients in Ethiopian tertiary care settings: A prospective cohort study

Negera

Mega

2019

PLoS ONE

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“…The median LOS of 11 days in our study is equal to the median reported by a similar study in Brazil [ 39 ]. Shorter LOS was reported by similar studies in Spain (8 days) [ 40 ], United Kingdom (7.5 days) [ 41 ], and the United States (6 days) [ 42 ].…”

Section: Discussionsupporting

confidence: 66%

Statistical models for analyzing count data: predictors of length of stay among HIV patients in Portugal using a multilevel model

Shaaban

Peleteiro

Martins

2021

BMC Health Serv Res

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Background This study offers a comprehensive approach to precisely analyze the complexly distributed length of stay among HIV admissions in Portugal. Objective To provide an illustration of statistical techniques for analysing count data using longitudinal predictors of length of stay among HIV hospitalizations in Portugal. Method Registered discharges in the Portuguese National Health Service (NHS) facilities Between January 2009 and December 2017, a total of 26,505 classified under Major Diagnostic Category (MDC) created for patients with HIV infection, with HIV/AIDS as a main or secondary cause of admission, were used to predict length of stay among HIV hospitalizations in Portugal. Several strategies were applied to select the best count fit model that includes the Poisson regression model, zero-inflated Poisson, the negative binomial regression model, and zero-inflated negative binomial regression model. A random hospital effects term has been incorporated into the negative binomial model to examine the dependence between observations within the same hospital. A multivariable analysis has been performed to assess the effect of covariates on length of stay. Results The median length of stay in our study was 11 days (interquartile range: 6–22). Statistical comparisons among the count models revealed that the random-effects negative binomial models provided the best fit with observed data. Admissions among males or admissions associated with TB infection, pneumocystis, cytomegalovirus, candidiasis, toxoplasmosis, or mycobacterium disease exhibit a highly significant increase in length of stay. Perfect trends were observed in which a higher number of diagnoses or procedures lead to significantly higher length of stay. The random-effects term included in our model and refers to unexplained factors specific to each hospital revealed obvious differences in quality among the hospitals included in our study. Conclusions This study provides a comprehensive approach to address unique problems associated with the prediction of length of stay among HIV patients in Portugal.

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“…In Madagascar, incidence rate of tuberculosis was estimated to 237 (153–338) per 100 000 among general population of which 5.6 (2.5–9.8) per 100 000 occurred among HIV positive in 2016 [ 21 ]. A decrease in hospitalizations due to ADE has been observed since widespread of highly active ART use in middle and high-income countries [ 8 , 13 , 22 , 23 ]. However, hospitalization rate and inpatient mortality remained high in Africa despite effective ART scale-up [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Hospitalization of HIV positive patients in a referral tertiary care hospital in Antananarivo Madagascar, 2010-2016: Trends, causes and outcome

et al. 2018

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BackgroundDuring the last few years, significant efforts have been made to improve access to antiretroviral therapy which led to dramatic reduction in AIDS-related events and mortality in HIV positive patients at the global level. However, current data in Africa suggested modest impact of widespread antiretroviral therapy scale-up especially regarding HIV-related hospitalization. In this study, we aimed to describe causes of hospitalization and factors associated with AIDS-defining events and inpatient mortality.Materials and methodsA retrospective study was performed on medical records of HIV positive patients admitted for at least 24 hours in the Infectious Diseases Unit of the University Hospital Joseph Raseta Befelatanana Antananarivo. Cause of hospitalization was considered as the main diagnosis related to the symptoms at admission. Diagnostic criteria were based on criteria described in WHO guidelines. AIDS-defining events were defined as diseases corresponding to WHO stage 4 or category C of CDC classification.ResultsFrom 2010 to 2016, 236 hospital admissions were included. AIDS-defining events were the most frequent cause of hospitalization (61.9%) with an increasing trend during the study period. Tuberculosis (28.4%), pneumocystis pneumonia (11.4%), cerebral toxoplasmosis (7.2%) and cryptococcosis (5.5%) were the most frequent AIDS-defining events. Tuberculosis was also the most frequent cause of overall hospitalization. In multivariate analysis, recent HIV diagnosis (aOR = 2.0, 95% CI: 1.0–3.9), CD4<200 cells/μl (aOR = 4.0, 95%CI: 1.9–8.1), persistent fever (aOR = 4.4, 95%CI: 2.1–9.0), duration of symptoms≥ 6 weeks (aOR = 2.6, 95%CI: 1.2–5.4) were associated with AIDS-defining events. Overall inpatient mortality was 19.5%. Age≥55 years (aOR = 4.9, 95%CI: 1.5–16.6), neurological signs (aOR = 3.2, 95%CI: 1.5–6.9) and AIDS-defining events (aOR = 2.9, 95%CI: 1.2–-7.2) were associated with inpatient mortality.ConclusionsAIDS-defining events were the most frequent cause of hospitalization during the study period. Factors associated with AIDS-defining events mostly reflected delay in HIV diagnosis. Factors associated with mortality were advanced age, neurological signs and AIDS-defining events.

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

Cited by 16 publications

References 18 publications

Clinical outcome of admitted HIV/AIDS patients in Ethiopian tertiary care settings: A prospective cohort study

Clinical outcome of admitted HIV/AIDS patients in Ethiopian tertiary care settings: A prospective cohort study

Statistical models for analyzing count data: predictors of length of stay among HIV patients in Portugal using a multilevel model

Hospitalization of HIV positive patients in a referral tertiary care hospital in Antananarivo Madagascar, 2010-2016: Trends, causes and outcome

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