Prognostic score of short-term survival in HIV-infected patients admitted to medical intensive care units.
A retrospective cohort was set up to identify prognostic factors associated with in-hospital survival in HIV-infected patients admitted to medical intensive care units (MICUs), from 1991 to 1994. Survival from MICU admission to hospital discharge (or in-hospital fatal issue) was estimated and a prognostic score at MICU admission was developed. One hundred and thirty patients were recruited of whom 20% were AIDS-free prior to admission. In-hospital mortality rate was 65%. Median survival was 20 days. The following variables were predictive of mortality: Simplified Acute Physioloy Score II (SAPS II): (hazard ratio [HR]=1.5 for 10 points higher, P<10(-3)), time between HIV diagnosis and admission >5 years (HR=2.7, P<10(-4)), hypoalbuminaemia (HR=1.2 per 5 g/l lower, P=0.03). The prognostic score developed was: SAPS II+25 (if time between HIV diagnosis and MICU admission >5 years) albuminaemia (g/l). A new prognostic score including SAPS II, prior HIV history and albuminaemia better reflected the in-hospital mortality than SAPS II alone. Our findings may still be useful to better evaluate the immediate prognosis of current HIV-infected patients admitted to MICU, particularly those naive to antiretroviral therapy or in treatment failure.
Bonarek
M
M
Department of Internal Medicine and Infectious Diseases, Bordeaux University Hospital, France. mojgan.bonarek@chu-bordeaux.fr
Morlat
P
P
Chêne
G
G
Rapin
D
D
Hilbert
G
G
Pillet
O
O
Gabinski
C
C
D018806:APACHE; D000328:Adult; D015331:Cohort Studies; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000401:mortality*; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D016019:Survival Analysis; D013997:Time Factors
D012709:Serum Albumin