title: Clinical Characteristics and Short-Term Outcomes of HIV Patients Admitted to an African Intensive Care Unit.
abstract: Purpose. In high-income countries, improved survival has been documented among intensive care unit (ICU) patients infected with human immune deficiency virus (HIV). There are no data from low-income country ICUs. We sought to identify clinical characteristics and survival outcomes among HIV patients in a low-income country ICU.Materials and Methods. A retrospective cohort study of HIV infected patients admitted to a university teaching hospital ICU in Uganda. Medical records were reviewed. Primary outcome was survival to hospital discharge. Statistical significance was predetermined in reference toP< 0.05.Results. There were 101 HIV patients. Average length of ICU stay was 4 days and ICU mortality was 57%. Mortality in non-HIV patients was 28%. Commonest admission diagnoses were Acute Respiratory Distress Syndrome (ARDS) (58.4%), multiorgan failure (20.8%), and sepsis (20.8%). The mean Acute Physiologic and Chronic Health Evaluation (APACHE II) score was 24. At multivariate analysis, APACHE II (OR 1.24 (95% CI: 1.1-1.4,P= 0.01)), mechanical ventilation (OR 1.14 (95% CI: 0.09-0.76,P= 0.01)), and ARDS (OR 4.5 (95% CI: 1.07-16.7,P= 0.04)) had a statistically significant association with mortality.Conclusion. ICU mortality of HIV patients is higher than in higher income settings and the non-HIV population. ARDS, APACHE II, and need for mechanical ventilation are significantly associated with mortality.
authors: Department of Anaesthesia, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda; International Health Sciences University and International Hospital Kampala, Kampala, Uganda.
authors: Arthur
authors: 0000-0002-7025-0465
authors: A
authors: Kwizera
authors: Department of Anaesthesia, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors: Mary
authors: M
authors: Nabukenya
authors: Department of Anaesthesia, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors: Agaba
authors: 0000-0002-2166-5517
authors: A
authors: Peter
authors: Department of Anaesthesia, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors: Lameck
authors: L
authors: Semogerere
authors: Department of Anaesthesia, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors: Emmanuel
authors: 0000-0001-8744-3960
authors: E
authors: Ayebale
authors: Department of Anaesthesia, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors: Catherine
authors: 0000-0002-1681-0206
authors: C
authors: Katabira
authors: Department of Clinical Epidemiology and Biostatistics, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors: Samuel
authors: 0000-0003-2413-0398
authors: S
authors: Kizito
authors: International Health Sciences University and International Hospital Kampala, Kampala, Uganda.
authors: Cecilia
authors: C
authors: Nantume
authors: International Health Sciences University and International Hospital Kampala, Kampala, Uganda.
authors: Ian
authors: I
authors: Clarke
authors: Department of Medicine, Makerere University College of Health Sciences, Mulago National Referral Hospital, P.O. Box 7051, Kampala, Uganda.
authors: Jane
authors: 0000-0003-0004-8867
authors: J
authors: Nakibuuka