title: Prognostic factors influencing the outcome in pneumocystis carinii pneumonia in patients with AIDS.
abstract: BACKGROUND
  Studies attempting to identify the prognostic factors that influence the outcome of Pneumocystis carinii pneumonia (PCP) in patients with AIDS using a multivariate analysis are few. In order to identify those prognostic factors amenable to medical intervention, univariate and multivariate analyses were performed on 102 patients with AIDS suffering a first episode of PCP.
  
  
  METHODS
  One hundred and two consecutive patients with AIDS (51% drug abusers, 45% homosexuals, and 4% with other HIV risk factors) admitted to our institution between 1986 and 1989 whose respiratory infection was diagnosed by bronchoalveolar lavage were studied prospectively.
  
  
  RESULTS
  The overall mortality was 28%, rising to 79% in those patients who required mechanical ventilation. According to univariate analysis the following variables were related to a poor prognosis: age > 35 years; risk factor for HIV infection other than drug abuse; and AIDS diagnosis confirmed before 1988; PaO2 < 8 kPa at admission; severe acute respiratory failure on admission (PaO2/FIO2 < 20 kPa); mechanical ventilation; antibiotic therapy for PCP other than trimethoprim-sulphamethoxazole; multiple microbial pulmonary infection; serum lactate dehydrogenase (LDH) > 22.5 mukat/l on admission; serum albumin level < 30 g/l. Multivariate analysis showed that only mechanical ventilation was independently associated with a poor outcome.
  
  
  CONCLUSIONS
  The mortality of AIDS patients presenting with a first episode of PCP before 1990 was high (28%). The main prognostic factor associated with poor outcome was the requirement for mechanical ventilation due to severe acute respiratory failure.
authors.affiliation: Hospital Clinic i Provincial, Departament de Medicina, Universitat de Barcelona, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Fernandez
authors.forename: A
authors.initials: A
authors.lastname: Torres
authors.forename: J M
authors.initials: JM
authors.lastname: Miro
authors.forename: C
authors.initials: C
authors.lastname: Vieigas
authors.forename: J
authors.initials: J
authors.lastname: Mallolas
authors.forename: L
authors.initials: L
authors.lastname: Zamora
authors.forename: J M
authors.initials: JM
authors.lastname: Gatell
authors.forename: M E
authors.initials: ME
authors.lastname: Valls
authors.forename: R
authors.initials: R
authors.lastname: Riquelme
authors.forename: R
authors.initials: R
authors.lastname: Rodríguez-Roisin
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000188:drug therapy; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012121:Respiration, Artificial; D012307:Risk Factors