The Coding Causes of Death in HIV (CoDe) Project

Kowalska, Justyna D.; Friis-Møller, Nina; Kirk, Ole; Bannister, Wendy; Mocroft, Amanda; Sabin, Caroline; Reiss, Peter; Gill, M. John; Lewden, Charlotte; Phillips, Andrew; Monforte, Antonella d’Arminio; Law, Matthew; Sterne, Jonathan A C; Wit, Stéphane De; Lundgren, Jens D.

doi:10.1097/ede.0b013e31821b5332

Cited by 134 publications

(73 citation statements)

References 31 publications

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“…However, the great majority of them lacked a standardized methodology to assess the causes of deaths [5–7, 35–37]. Using a standardized protocol to ascertain causes of death [10] we were able to demonstrate that invasive bacterial infections is the most frequent immediate cause of death among patients with HIV-1/TB coinfection in our cohort. This is particularly relevant when we consider the early deaths, as previously shown by our group [8] and others [38, 39].…”

Section: Discussionmentioning

confidence: 91%

“…We were able to assess mortality outcomes with detailed socio-demographic, clinical, laboratory and treatment data, including the cause of death ascertainment. The CoDe method, used in our analysis is a reliable tool to assess death causality [10]. Existing medical record data was checked for accuracy, active contact with individuals or family members was established and Rio de Janeiro mortality database was consulted in order to ascertain each patient’s vital status.…”

Section: Discussionmentioning

confidence: 99%

“…The “Coding of Death in HIV” (CoDe) protocol was used to standardize causes of death report [10, 11]. …”

Section: Methodsmentioning

confidence: 99%

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Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death

et al. 2017

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BackgroundTuberculosis is the most frequent opportunistic infection and the leading cause of death among persons living with HIV in several low and middle-income countries. Mortality rates during tuberculosis treatment and death causes among HIV-1/TB co-infected patients may differ based on the immunosuppression severity, timing of diagnosis and prompt initiation of tuberculosis and antiretroviral therapy.MethodsThis was a retrospective observational study conducted in the clinical cohort of patients with HIV-1/Aids of the National Institute of Infectious Diseases Evandro Chagas, Rio de Janeiro, Brazil. All HIV-1 infected patients who started combination antiretroviral therapy up to 30 days before or within 180 days after the start of tuberculosis treatment from 2000 to 2010 were eligible. Causes of death were categorized according to the "Coding Causes of Death in HIV” (CoDe) protocol. The Cox model was used to estimate the hazard ratio (HR) of selected mortality variables.ResultsA total of 310 patients were included. Sixty-four patients died during the study period. Mortality rate following tuberculosis treatment initiation was 44 per 100 person-years within the first 30 days, 28.1 per 100 person-years within 31 and 90 days, 6 per 100 person-years within 91 and 365 days and 1.6 per 100 person-years after 365 days. Death probability within one year from tuberculosis treatment initiation was approximately 13%. In the adjusted analysis the associated factors with mortality were: CD4 ≤ 50 cells/mm3 (HR: 3.10; 95% CI: 1.720 to 5.580; p = 0.00); mechanical ventilation (HR: 2.81; 95% CI: 1.170 to 6.760; p = 0.02); and disseminated tuberculosis (HR: 3.70; 95% CI: 1.290 to 10.590, p = 0.01). Invasive bacterial disease was the main immediate cause of death (46.9%).ConclusionOur results evidence the high morbidity and mortality among patients co-infected with HIV-1 and tuberculosis in Rio de Janeiro, Brazil. During the first year following tuberculosis diagnosis, mortality was the highest within the first 3 months, being invasive bacterial infection the major cause of death. In order to successfully intervene in this scenario, it is utterly necessary to address the social determinants of health contributing to the inequitable health care access faced by this population.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death

et al. 2017

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“…We compiled a dataset with follow-up on >65 000 patients who experienced >4000 deaths. Thanks to a team of experienced HIV clinicians using standardized procedures, 3574 (84%) deaths were classified as due to specific causes [19]. Disagreements were carefully resolved via panel discussion.…”

Section: Discussionmentioning

confidence: 99%

Impact of Risk Factors for Specific Causes of Death in the First and Subsequent Years of Antiretroviral Therapy Among HIV-Infected Patients

Ingle

May

Gill

et al. 2014

Clinical Infectious Diseases

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141

112

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“…All other deaths with known cause were classified as non-HIV. In ART-CC, deaths were classified based both on ICD codes and on relevant clinical information, using the code classification system, as described previously [23,24]. VACS COD information was not available at the time of the ART-CC adjudication process.…”

Section: Methodsmentioning

confidence: 99%

An internationally generalizable risk index for mortality after one year of antiretroviral therapy

Tate

Justice

Hughes

et al. 2013

Aids

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177

166

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Objective Despite the success of antiretroviral therapy (ART), excess mortality continues for those with HIV infection. A comprehensive approach to risk assessment, addressing multiorgan system injury on ART, is needed. We sought to develop and validate a practical and generalizable mortality risk index for HIV-infected individuals on ART. Design and methods The Veterans Aging Cohort Study (VACS) was used to develop the VACS Index, based on age, CD4 cell count, HIV-1 RNA, hemoglobin, aspartate and alanine transaminase, platelets, creatinine and hepatitis C status, and a Restricted Index based on age, CD4 cell count and HIV-1 RNA with an outcome of death up to 6 years after ART initiation. Validation was in six independent cohorts participating in the ART Cohort Collaboration (ART-CC). Results In both the development (4932 patients, 656 deaths) and validation cohorts (3146 patients, 86 deaths) the VACS Index had better discrimination than the Restricted Index (c-statistics 0.78 and 0.72 in VACS, 0.82 and 0.78 in ART-CC). The VACS Index also demonstrated better discrimination than the Restricted Index for HIV deaths and non-HIV deaths, in men and women, those younger and older than 50 years, with and without detectable HIV-1 RNA, and with or without HCV coinfection. Conclusions Among HIV-infected patients treated with ART, the VACS Index more accurately discriminates mortality risk than traditional HIV markers and age alone. By accounting for multiorgan system injury, the VACS Index may prove a useful tool in clinical care and research.

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The Coding Causes of Death in HIV (CoDe) Project

Abstract: The extent and format of data collected in the CoDe Project appear to be sufficient for an informed review, and the proposed coding scheme is adequate for obtaining an underlying cause of death.

Cited by 134 publications

References 31 publications

Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death

Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death

Impact of Risk Factors for Specific Causes of Death in the First and Subsequent Years of Antiretroviral Therapy Among HIV-Infected Patients

An internationally generalizable risk index for mortality after one year of antiretroviral therapy

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