Clinical Characteristics and Short-Term Outcomes of HIV Patients Admitted to an African Intensive Care Unit.
Arthur KwizeraMary NabukenyaAgaba PeterLameck SemogerereEmmanuel AyebaleCatherine KatabiraSamuel KizitoCecilia NantumeIan ClarkeJane NakibuukaPublished in: Critical care research and practice (2016)
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 to P < 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.
Keyphrases
- mechanical ventilation
- intensive care unit
- acute respiratory distress syndrome
- hiv infected
- antiretroviral therapy
- end stage renal disease
- newly diagnosed
- hiv positive
- human immunodeficiency virus
- chronic kidney disease
- ejection fraction
- hepatitis c virus
- extracorporeal membrane oxygenation
- emergency department
- risk factors
- cardiovascular disease
- public health
- peritoneal dialysis
- endothelial cells
- risk assessment
- coronary artery disease
- physical activity
- patient reported outcomes
- electronic health record
- human health
- artificial intelligence