title: Causes of Death Among Patients Infected with HIV at a Tertiary Care Hospital in China: An Observational Cohort Study.
abstract: The objective of this study was to elucidate the causes of death and mortality in a cohort of inpatients infected with HIV. The causes of death and mortality were evaluated by using the clinical data of 1,076 patients admitted to the Center for Infectious Diseases, Beijing Ditan Hospital, between January 1, 2009, and November 30, 2012, and who were followed for 6 months after discharge. During the 4-year study period, 216 patients had died by the 6-month follow-up (mortality rate, 20.1%). Opportunistic infections were the most common causes of death (42.0%), followed by malignancies (23.1%), unexplained central nervous system infections and occupying lesions (18.1%), infectious shock (10.2%), severe hepatitis and decompensated cirrhosis (3.2%), sudden death (1.4%), lactic acidosis (0.9%), and uremia (0.9%). The strong risk factors for mortality were cost constraints and unaffordable further diagnosis and treatment (adjusted hazard ratio [AHR] = 134.394, 95% confidence interval [CI] = 25.748-701.481, p < .001), unexplained etiologies (AHR = 12.551, 95% CI = 6.642-23.716, p < .001), and multiple complications (AHR = 5.798, 95% CI = 2.973-11.308, p < .001). Mortality was not associated with CD4 levels or combined antiretroviral therapy (cART) in a cohort of inpatients at a special hospital for HIV/AIDS patients in China. AIDS-related infections and malignancies were the most common causes of death in patients infected with HIV, and improvement of the etiological diagnosis would help physicians provide appropriate treatment and reduce mortality rates.
authors.affiliation: 1 The National Clinical Key Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University , Beijing, China .
authors.forename: Jiang
authors.initials: J
authors.lastname: Xiao
authors.affiliation: 2 Beijing Shijitan Hospital, Capital Medical University , Beijing, China .
authors.forename: Shuxu
authors.initials: S
authors.lastname: Du
authors.affiliation: 1 The National Clinical Key Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University , Beijing, China .
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Tian
authors.affiliation: 1 The National Clinical Key Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University , Beijing, China .
authors.forename: Wenjing
authors.initials: W
authors.lastname: Su
authors.affiliation: 1 The National Clinical Key Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University , Beijing, China .
authors.forename: Di
authors.initials: D
authors.lastname: Yang
authors.affiliation: 1 The National Clinical Key Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University , Beijing, China .
authors.forename: Hongxin
authors.initials: H
authors.lastname: Zhao
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D002423:Cause of Death / Q000639:trends*; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000401:mortality* / Q000821:virology; D006505:Hepatitis / Q000150:complications / Q000401:mortality* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000401:mortality* / Q000821:virology; D009420:Nervous System / Q000473:pathology / Q000821:virology; D009894:Opportunistic Infections / Q000150:complications / Q000401:mortality* / Q000821:virology; D016016:Proportional Hazards Models; D012772:Shock, Septic / Q000150:complications / Q000401:mortality* / Q000821:virology; D062606:Tertiary Care Centers / Q000706:statistics & numerical data