Abstract | BACKGROUND: OBJECTIVE: To assess the effects of HAART on outcome of patients admitted to the intensive care unit (ICU) with PCP. DESIGN AND SETTING: Retrospective cohort study carried out at a University-affiliated county hospital. PARTICIPANTS: Fifty-eight HIV-infected adults with PCP admitted to an ICU from 1996 to 2001. MEASUREMENTS: A standardized chart review was performed to collect information on demographic variables, hospital course, and use of antiretroviral therapy. Outcome measured was death while in the ICU or hospital. RESULTS: A total of 20.7% of patients were either receiving HAART or were started on therapy while hospitalized. Mortality in this group was 25%, whereas mortality in those not receiving therapy was 63% (P = 0.03). Multiple logistic regression analyses adjusting for potential confounders showed that HAART started either before or during hospitalization was associated with a lower mortality [odds ratio (OR), 0.14; 95% confidence interval (95% CI), 0.02-0.84; = 0.03). The need for mechanical ventilation and/or development of a pneumothorax (OR, 20.9; 95% CI, 1.9-227.2; = 0.01) and delayed ICU admission (OR, 9.7; 95% CI, 2.2-42.1; = 0.002) were associated with increased mortality. CONCLUSIONS: Use of HAART is an independent predictor of decreased mortality in severe PCP and may represent a potential therapy to improve outcome in this disease.
|
Authors | Alison Morris, Robert M Wachter, John Luce, Joan Turner, Laurence Huang |
Journal | AIDS (London, England)
(AIDS)
Vol. 17
Issue 1
Pg. 73-80
(Jan 03 2003)
ISSN: 0269-9370 [Print] England |
PMID | 12478071
(Publication Type: Journal Article)
|
Topics |
- AIDS-Related Opportunistic Infections
(drug therapy)
- Acute Disease
- Adult
- Antiretroviral Therapy, Highly Active
- Critical Care
- Female
- Hospital Mortality
- Humans
- Logistic Models
- Male
- Middle Aged
- Pneumonia, Pneumocystis
(drug therapy)
- Retrospective Studies
- Risk Factors
- Survival Rate
- Treatment Outcome
|