Sepsis is a major determinant of outcome in HIV/AIDS critically ill patients

Detalhes bibliográficos
Autor(a) principal: Japiassú, André M.
Data de Publicação: 2010
Outros Autores: Amancio, Rodrigo T., Mesquita, Emerson C., Medeiros, Denise M., Bernal, Helena B., Nunes, Estevao P., Luz, Paula M., Grinsztejn, Beatriz, Bozza, Fernando A.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/37437
Resumo: Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil.
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spelling Japiassú, André M.Amancio, Rodrigo T.Mesquita, Emerson C.Medeiros, Denise M.Bernal, Helena B.Nunes, Estevao P.Luz, Paula M.Grinsztejn, BeatrizBozza, Fernando A.2019-11-28T12:03:57Z2019-11-28T12:03:57Z2010JAPIASSÚ, André M. et al. Sepsis is a major determinant of outcome in critically ill HIV/AIDS patients. Critical Care, v. 14, p. 1-8, 2010.1364-8535https://www.arca.fiocruz.br/handle/icict/3743710.1186/cc92211466-609XengBMCSepsis is a major determinant of outcome in HIV/AIDS critically ill patientsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil.Introduction: New challenges have arisen for the management of critically ill HIV/AIDS patients. Severe sepsis has emerged as a common cause of intensive care unit (ICU) admission for those living with HIV/AIDS. Contrastingly, HIV/AIDS patients have been systematically excluded from sepsis studies, limiting the understanding of the impact of sepsis in this population. We prospectively followed up critically ill HIV/AIDS patients to evaluate the main risk factors for hospital mortality and the impact of severe sepsis on the short- and long-term survival. Methods: All consecutive HIV-infected patients admitted to the ICU of an infectious diseases research center, from June 2006 to May 2008, were included. Severity of illness, time since AIDS diagnosis, CD4 cell count, antiretroviral treatment, incidence of severe sepsis, and organ dysfunctions were registered. The 28-day, hospital, and 6-month outcomes were obtained for all patients. Cox proportional hazards regression analysis measured the effect of potential factors on 28-day and 6-month mortality. Results: During the 2-year study period, 88 HIV/AIDS critically ill patients were admitted to the ICU. Seventy percent of patients had opportunist infections, median CD4 count was 75 cells/mm3 , and 45% were receiving antiretroviral therapy. Location on a ward before ICU admission, cardiovascular and respiratory dysfunctions on the first day after admission, and the presence of severe sepsis/septic shock were associated with reduced 28-day and 6-month survival on a univariate analysis. After a multivariate analysis, severe sepsis determined the highest hazard ratio (HR) for 28-day (adjusted HR, 3.13; 95% CI, 1.21-8.07) and 6-month (adjusted HR, 3.35; 95% CI, 1.42-7.86) mortality. Severe sepsis occurred in 44 (50%) patients, mainly because of lower respiratory tract infections. The survival of septic and nonseptic patients was significantly different at 28-day and 6-month follow-up times (logrank and Peto test, P < 0.001). Conclusions: Severe sepsis has emerged as a major cause of admission and mortality for hospitalized HIV/AIDS patients, significantly affecting short- and longer-term survival of critically ill HIV/AIDS patients.SepsisHIV/AIDS patientsCritically illinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txttext/plain1748https://www.arca.fiocruz.br/bitstream/icict/37437/1/license.txt8a4605be74aa9ea9d79846c1fba20a33MD51ORIGINALve_Japiassú_André_etal_INI_2010.pdfve_Japiassú_André_etal_INI_2010.pdfapplication/pdf326444https://www.arca.fiocruz.br/bitstream/icict/37437/2/ve_Japiass%c3%ba_Andr%c3%a9_etal_INI_2010.pdf176fa7e5a33453c31a87f95cfc16a782MD52TEXTve_Japiassú_André_etal_INI_2010.pdf.txtve_Japiassú_André_etal_INI_2010.pdf.txtExtracted texttext/plain43075https://www.arca.fiocruz.br/bitstream/icict/37437/3/ve_Japiass%c3%ba_Andr%c3%a9_etal_INI_2010.pdf.txta068fe49380c1b11509819c07e8fb9a4MD53icict/374372019-11-29 02:02:29.829oai:www.arca.fiocruz.br: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Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352019-11-29T05:02:29Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.pt_BR.fl_str_mv Sepsis is a major determinant of outcome in HIV/AIDS critically ill patients
title Sepsis is a major determinant of outcome in HIV/AIDS critically ill patients
spellingShingle Sepsis is a major determinant of outcome in HIV/AIDS critically ill patients
Japiassú, André M.
Sepsis
HIV/AIDS patients
Critically ill
title_short Sepsis is a major determinant of outcome in HIV/AIDS critically ill patients
title_full Sepsis is a major determinant of outcome in HIV/AIDS critically ill patients
title_fullStr Sepsis is a major determinant of outcome in HIV/AIDS critically ill patients
title_full_unstemmed Sepsis is a major determinant of outcome in HIV/AIDS critically ill patients
title_sort Sepsis is a major determinant of outcome in HIV/AIDS critically ill patients
author Japiassú, André M.
author_facet Japiassú, André M.
Amancio, Rodrigo T.
Mesquita, Emerson C.
Medeiros, Denise M.
Bernal, Helena B.
Nunes, Estevao P.
Luz, Paula M.
Grinsztejn, Beatriz
Bozza, Fernando A.
author_role author
author2 Amancio, Rodrigo T.
Mesquita, Emerson C.
Medeiros, Denise M.
Bernal, Helena B.
Nunes, Estevao P.
Luz, Paula M.
Grinsztejn, Beatriz
Bozza, Fernando A.
author2_role author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Japiassú, André M.
Amancio, Rodrigo T.
Mesquita, Emerson C.
Medeiros, Denise M.
Bernal, Helena B.
Nunes, Estevao P.
Luz, Paula M.
Grinsztejn, Beatriz
Bozza, Fernando A.
dc.subject.en.pt_BR.fl_str_mv Sepsis
HIV/AIDS patients
Critically ill
topic Sepsis
HIV/AIDS patients
Critically ill
description Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Unidade de Terapia Intensiva. Rio de Janeiro, RJ, Brasil.
publishDate 2010
dc.date.issued.fl_str_mv 2010
dc.date.accessioned.fl_str_mv 2019-11-28T12:03:57Z
dc.date.available.fl_str_mv 2019-11-28T12:03:57Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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status_str publishedVersion
dc.identifier.citation.fl_str_mv JAPIASSÚ, André M. et al. Sepsis is a major determinant of outcome in critically ill HIV/AIDS patients. Critical Care, v. 14, p. 1-8, 2010.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/37437
dc.identifier.issn.pt_BR.fl_str_mv 1364-8535
dc.identifier.doi.none.fl_str_mv 10.1186/cc9221
dc.identifier.eissn.none.fl_str_mv 1466-609X
identifier_str_mv JAPIASSÚ, André M. et al. Sepsis is a major determinant of outcome in critically ill HIV/AIDS patients. Critical Care, v. 14, p. 1-8, 2010.
1364-8535
10.1186/cc9221
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url https://www.arca.fiocruz.br/handle/icict/37437
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dc.publisher.none.fl_str_mv BMC
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