Thirty-day readmission rates in a cohort of people living with HIV in southern Brazil, 2015 to 2017

Abstract

Background The intense use of antiretroviral therapy (ART) has reduced morbidity and mortality of HIV infection. In Brazil, the specific contribution of diseases related to HIV infection leading to hospital admission and readmission is not well known. Aims The study aimed to determine the clinico-epidemiological profile, 30-day readmission rate, and factors associated with this outcome in a cohort of adults with HIV infection in southern Brazil. Methods Unicentric retrospective cohort, with data collection through the review of medical records and databases. Results We analyzed 574 index hospitalizations and 451 individuals. Of these, 57.6% were men and the mean (±SD) age was 42.2 ± 12.3 years. Only 43.4% used ART regularly and low CD4 count and high frequency of detectable viral load were observed. HIV/AIDS-related diseases were identified in 55.2%, and tuberculosis was the most frequent etiology leading to index hospitalization. We found a 30-day readmission rate of 11.5% and hospitalization for HIV/AIDS-related illness was associated with a higher risk for the outcome. Conclusions These findings highlight the need to expand resources for prevention, early diagnosis, retention, and treatment of people living with HIV in the region to reduce HIV/AIDS-associated diseases and possibly minimize consequent hospital readmission of these individuals.

Factors associated with readmission risk in patients with HIV stratified by BMI: a hospital-based retrospective study

“…In patients with HIV treated with ART using a controlled viral load, the immune response was related to BMI, and patients with low BMI had a lower immune response rate and longer immune function recovery time [32][33]. When CD4+ T cell count was < 200/µL, bacterial meningitis and neurosyphilis were more common, and when CD4+ T cell count was < 100/µL, common cryptococcal infection was more common-as patients with cryptococcal infection are prone to reinfection, this results in increased hospitalization [34]. Early clinical detection of individuals with lower CD4+ T cell counts, especially in patients with a baseline BMI < 18.5 kg/m 2 , and aggressive use of prophylactic therapy is essential to reduce readmission.…”

Characteristics and risk factors for readmission in HIV-infected patients with Talaromyces marneffei infection

“…Therefore, clinicians could perform early pathogenetic testing, providing early intervention and comprehensive care during the first hospitalization, which helps to control infections promptly and reduce the incidence of complications. Previous studies have reported that regular follow-up after discharge, enhanced surveillance, and early outpatient intervention when problems arise can reduce the hospital readmission rate of AIDS patients [ 31 , 32 ].…”