ICU admission in patients infected with the human immunodeficiency virus — a multicentre survey

Abstract

We conducted a retrospective study to assess the reasons for admission to the intensive care unit, and subsequent outcome, in patients infected with the human immunodeficiency virus (HIV). Four hospitals in the south of England participated, all with specialist HIV units. Data were collected on 127 patients admitted to ICU on 133 separate occasions between June 1993 and October 1997. The mean age on admission was 38 years (range 23–60 years). Ninety‐four patients (70.7%) were documented HIV‐positive before admission and 36 (27%) were diagnosed HIV‐positive for the first time during admission; 36.1% were admitted with Pneumocystis carinii pneumonia. Overall ICU mortality was 33%, in‐hospital mortality was 56% and the eventual mortality at the end of follow‐up (March 1998) was 72%. Survival was highest in those admitted with respiratory HIV‐related disease or HIV‐unrelated illness. Associations with poor outcome included a prior AIDS‐defining illness, a CD4 cell count of less than 100 cells.ml−1 and admission secondary to sepsis.

Impact of HAART advent on admission patterns and survival in HIV-infected patients admitted to an intensive care unit

“…The short-term mortality rate of HIV-infected patients in the present study was similar to the rates reported in the pre-HAART era [5,[8][9][10][11][12][13][14][15]. In-ICU mortality did not change between the pre-HAART and HAART era.…”

“…The present study provides the first HAART-era data on long-term survival of HIV-infected patients after ICU discharge. Clearly, the median and mean survival times reported here, as well as the cumulative survival after ICU discharge, were far better than in earlier studies [5,7,9,10,13,14]. We found significant improvements in survival times between the pre-HAART and HAART eras.…”

“…We found 1-and 2-year survival rates of 85% and 71%, respectively, with an overall median survival time of 30 months (565 days). Previously reported 1-year survival rates in HIVpatients discharged alive from the ICU in the pre-HAART era ranged from 28% to 44% [5,7,9,10]. The present study provides the first HAART-era data on long-term survival of HIV-infected patients after ICU discharge.…”

“…The reasons for admission to an intensive care unit (ICU), prognostic markers, and short-and long-term survival of HIV-infected patients admitted to the ICU have been extensively reported [5][6][7][8][9][10][11][12][13][14][15]. However, there are few data on HIV-infected patients admitted to the ICU in the HAART era [5][6][7].…”

Przyczyny hospitalizacji chorych zakażonych wirusem HIV na oddziale intensywnej terapii — jednoośrodkowe badanie obserwacyjne

“…Until the mid-90 ties, respiratory failure associated predominantly with Pneumocystis pneumonia (PCP) was the main reason for ICU hospitalization of HIV patients associated with high mortality [5,6]. Further studies, connected with the introduction of HAART, have demonstrated improved survival, even amongst PCP patients [7,8]. At present, respiratory failure is still the most common indication for ICU admission [9,10], although PCP as a cause of respiratory failure is substantially less common.…”