title: Clinical outcome and predictors of survival in patients with pneumocystis jirovecii pneumonia--results of a tertiary referral centre.
abstract: OBJECTIVE
  Pneumocystis jirovecii pneumonia also known as pneumocystis pneumonia (PCP) is an opportunistic respiratory infection in human immunodeficiency virus (HIV) patients that may also develop in non-HIV immunocompromised persons. The aim of our study was to evaluate mortality predictors of PCP patients in a tertiary referral centre.
  
  
  METHODS
  Fifty-one patients with symptomatic PCP were enrolled in the study. The patients had either HIV infection (n = 21) or other immunosuppressive conditions (n = 30). Baseline characteristics (e.g. age, sex and underlying disease) were retrieved. Kaplan-Meier analysis was employed to calculate survival. Comparisons were made by log-rank test. A multivariate analysis of factors influencing survival was carried out using the Cox regression model. Chi-squared test and Wilcoxon-Mann-Whitney test was applied as appropriate.
  
  
  RESULTS
  The median survival time for the HIV group was >120 months compared with 3 months for the non-HIV group (P = 0.009). Three-month survival probability was also significantly greater in the HIV group compared with the non-HIV group (90% vs 41%, P = 0.002). In univariate log-rank test, intensive care unit (ICU) necessity, HIV negativity, age >50 years, haemoglobin <10g/dl, C-reactive protein >5 mg/dL and multiple comorbidities were significant negative predictors of survival. In the Cox regression model, ICU and HIV statuses turned out to be independent prognostic factors of survival.
  
  
  CONCLUSIONS
  PCP is a serious problem in non-HIV immunocompromised patients in whom survival outcomes are worse than those in HIV patients.
authors.affiliation: Department of Medicine B, Muenster University Hospital, Muenster, Germany.
authors.forename: Felicitas
authors.initials: F
authors.lastname: Roembke
authors.forename: Hauke Sebastian
authors.initials: HS
authors.lastname: Heinzow
authors.forename: Thomas
authors.initials: T
authors.lastname: Gosseling
authors.forename: Achim
authors.initials: A
authors.lastname: Heinecke
authors.forename: Dirk
authors.initials: D
authors.lastname: Domagk
authors.forename: Wolfram
authors.initials: W
authors.lastname: Domschke
authors.forename: Tobias
authors.initials: T
authors.lastname: Meister
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000401:mortality*; D000328:Adult; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D016867:Immunocompromised Host; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology / Q000401:mortality*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: HIV; non-HIV; pneumocystis pneumonia; predictors of survival