Table 4 |
||||||||
|
Comparisons of studies regarding HIV-infected patients admitted to ICU in the HAART era |
||||||||
|
City [reference] |
San Francisco [8] |
San Francisco [16] |
New York [20] |
Paris [18] |
Mexico [14] |
São Paulo [15] |
Rio de Janeiro [19] |
Taipei |
|
|
||||||||
|
Study year |
1996-1999 |
2000-2004 |
1997-1999 |
1996-2005 |
1996-2006 |
1996-2006 |
2006-2008 |
2001-2010 |
|
HIV-related characteristics |
||||||||
|
Newly diagnosed HIV (%) |
5.6 |
- |
- |
19.7a |
26 |
38 |
28 |
44.4 |
|
Median CD4 count (cells/mm3) |
64 |
109 |
85 |
- |
- |
39 |
75 |
30 |
|
ICU admission diagnosis (%) |
||||||||
|
Respiratory failure (%) |
40.7 |
42.3 |
30.0 |
58.8 |
51.0 |
33.1 |
29 |
44.4 |
|
pneumocystosis (%) |
10.7 |
13.8 |
- |
18.7 |
- |
23.2 |
- |
8.1b |
|
Sepsis (%) |
11.9 |
20.3 |
13.0 |
23.9 |
26.0 |
31.2 |
20.5 |
33.3 |
|
Neurological disease (%) |
12.4 |
16.3 |
18.0 |
32 |
15.0 |
19.4 |
22.7 |
11.9 |
|
Others (%) |
35.0 |
21.1 |
39.0 |
- |
21.0 |
16.2 |
27.3 |
13.3 |
|
Mortality predictors |
||||||||
|
ART use |
No prior HAART univariably increased hospital mortality, 1.8 (1.02-3.2), but not significantly in multivariable analysis |
No association |
No association |
No association |
No prior HAART independently increased ICU mortality, 3.33 (1.43-10.0)c |
No ART use in ICU independently increased 6-month mortality, 2.00 (1.41-2.86) |
No association |
No association |
|
CD4 count (cells/mm3) |
- |
- |
CD4 < 200 univariably increased hospital mortality, 2.24 (1.16-4.31), but not significantly in multivariable analysis |
No association |
- |
CD4 < 50 independently increased ICU mortality, 2.10 (1.17-3.76) |
No association |
CD4 (per 10-cells/mm3 decrease) independently increased hospital mortality, 1.036 (1.003-1.069) |
|
Admission diagnosis of sepsis |
- |
No significant difference between with sepsis and respiratory failure |
- |
Severe sepsis independently increased ICU mortality, 3.67 (1.53-8.80) |
Septic shock independently increased ICU mortality, 2.4 (1.1-5.2)c |
Sepsis independently increased ICU mortality, 3.16 (1.65-6.06) |
Severe sepsis/septic shock independently increased 28-day mortality, 3.13 (1.21-8.07)c |
Sepsis independently increased hospital mortality, 2.91 (1.11-7.62) |
|
Hospital-to-ICU interval |
- |
- |
- |
Delayed ICU admission independently increased ICU mortality, 3.04 (1.29-7.71) |
- |
- |
- |
Hospital-to-ICU interval > 24 hours univariably increased hospital mortality, 2.72 (1.23-6.01), but not significantly in multivariable analysis |
|
Serum albumin level (g/dL) |
Serum albumin < 2.6 independently increased hospital mortality, 3.5 (1.8-6.6) |
Lower serum albumin (per 1-g/dl decrease) independently increased hospital mortality, 2.08 (1.41-3.06) |
- |
- |
No association |
No association |
- |
Lower serum albumin (per 1-g/dl decrease) univariably increased hospital mortality, 1.69 (1.04-2.74), but not significantly in multivariable analysis |
|
|
||||||||
|
Values are given as odds ratio (95% confidence interval), unless otherwise indicated. aHIV diagnosis within 60 days before ICU admission. bDiagnosis was based on identification of Pneumocystis in the sputum, bronchoalveolar-lavage fluid, or transbronchoscopic or surgical lung biopsy. cValues are given as hazard ratio (95% confidence interval). ART, antiretroviral therapy; HAART, highly active antiretroviral therapy. |
||||||||
|
Chiang et al. Critical Care 2011 15:R202 doi:10.1186/cc10419 |
||||||||
