Pronóstico de los pacientes VIH positivos ingresados en UCI

Choperena, G.; Arcega, I.; Marco, P.; Mintegi, I.; Reviejo, Karlos; Murgialdai, A.; Azkarate, B.; Lara, Gladys

doi:10.1016/s0210-5691(00)79633-1

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…In the pre-ART era, admission for CNS compromise was associated with a 68% three-month mortality [11,16,18,28,32]. Recently, mortality improvements have been reported in this group of patients except for patients with a diagnosis of HIV at late stages and without ART, which may explain the association with mortality found in this study [18,28,32]. Similar to historical reports, the most frequent diagnoses in this group of patients were toxoplasmosis and cryptococcosis [1].…”

Section: Discussionsupporting

confidence: 82%

“…Considering that tuberculosis leading to ICU admission in HIV-infected patients has been associated with an increased mortality risk, strategies that lead to early diagnosis and treatment of active and latent tuberculosis could alter the prognosis of HIV-infected patients in the ICU. However, despite the elevated frequency of OIs, mortality was not directly associated with their presence (nor tuberculosis, specifically) in the present study [18,28,29].…”

Section: Discussioncontrasting

confidence: 74%

“…Although admission for CNS compromise has been consistently reported to be one of the top three indications for ICU admission, its association to mortality is controversial. In the pre-ART era, admission for CNS compromise was associated with a 68% three-month mortality [11,16,18,28,32]. Recently, mortality improvements have been reported in this group of patients except for patients with a diagnosis of HIV at late stages and without ART, which may explain the association with mortality found in this study [18,28,32].…”

Section: Discussionsupporting

confidence: 49%

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HIV/AIDS infection in critical care: epidemiological profile and risk factors for mortality in a Colombian cohort

Gaviria

Zapata

Villa

et al. 2023

J Infect Dev Ctries

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Introduction: Outcomes of human immunodeficiency virus (HIV) infected patients admitted to intensive care units (ICU) have improved with antiretroviral therapy (ART). However, whether the outcomes have improved in low- and middle-income countries, paralleling those of high-income countries is unknown. The objective of this study was to describe a cohort of HIV-infected patients admitted to ICU in a middle-income country and identify the risk factors associated with mortality. Methodology: A cohort study of HIV-infected patients admitted to five ICUs in Medellín, Colombia, between 2009 and 2014 was done. The association of demographic, clinical and laboratory variables with mortality was analyzed using a Poisson regression model with random effects. Results: During this time period, 472 admissions of 453 HIV-infected patients were included. Indications for ICU admission were: respiratory failure (57%), sepsis/septic shock (30%) and central nervous system (CNS) compromise (27%). Opportunistic infections (OI) explained 80% of ICU admissions. Mortality rate was 49%. Factors associated with mortality included hematological malignancies, CNS compromise, respiratory failure, and APACHE II score ≥ 20. Conclusions: Despite advances in HIV care in the ART era, half of HIV-infected patients admitted to the ICU died. This elevated mortality was associated to underlying disease severity (respiratory failure and APACHE II score ≥ 20), and host conditions (hematological malignancies, admission for CNS compromise). Despite the high prevalence of OIs in this cohort, mortality was not directly associated to OIs.

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