Mortality descriptors in HIV inpatients

Detalhes bibliográficos
Autor(a) principal: Thuler, Luiz Claudio Santos
Data de Publicação: 1998
Outros Autores: Hatherly, André Luís, Góes, Patrícia Nascimento, Silva, Jorge Roberto de Almeida e
Tipo de documento: Artigo
Idioma: por
Título da fonte: Revista de Saúde Pública
Texto Completo: https://www.revistas.usp.br/rsp/article/view/24420
Resumo: OBJECTIVE: To assess the clinical-epidemiological descriptors of inpatient mortality in persons infected with the human immunodeficiency virus (HIV). METHOD: All adult HIV/AIDS patients hospitalized at a university hospital in 1990, 1992 and 1994 were studied retrospectively. Descriptive statistics for all variables of interest were generated. Chi-square test and Fisher's exact test were performed to compare categorical variables. Means were compared using the Student t test. Stepwise logistic regression was used to identify the odds of dying associated with each risk factor. RESULTS: Two hundred and forty patients were included in the study. Between 1990 and 1994 the mean age rose from 35 to 36.9 years, the male/female ratio decreased from 9.8 to 2.0, the non-white proportion increased from 18.5 to 41.3% and the mean time between detection of HIV infection and hospitalization rose from 0.7 to 2.5 years. In addition, length of stay dropped from 31.3 to 25.3 days and the proportion of patients being followed up in the outpatient clinic of the Universitary Hospital increased from 47.8 to 83.3%. Respiratory infections were the main cause of hospitalization (58.0%). Oral candidiasis (27.1%), tuberculosis (18.3%), Pneumocystis carinii pneumonia (15.4%) and toxoplasmic encephalitis (10.4%) were the most frequent opportunistic infections. Multivariate analysis showed that the factors associated with a worse outcome included the length of stay less than or equal to 7 days (Odds Ratio [OR]=3.88; p=0.02) and no outpatient follow-up at the Hospital (OR=3.29; p=0.01). CONCLUSION: Identification of independent risk factors for death may help in the implementation of more efficient interventions directed towards inpatients with HIV/AIDS.
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spelling Mortality descriptors in HIV inpatients Infecção pelo HIV: descritores de mortalidade em pacientes hospitalizados Síndrome de imunodeficiência adquiridaTempo de internaçãoMortalidade hospitalarAcquired immunodeficiency syndromeLenth of stayHospital mortality OBJECTIVE: To assess the clinical-epidemiological descriptors of inpatient mortality in persons infected with the human immunodeficiency virus (HIV). METHOD: All adult HIV/AIDS patients hospitalized at a university hospital in 1990, 1992 and 1994 were studied retrospectively. Descriptive statistics for all variables of interest were generated. Chi-square test and Fisher's exact test were performed to compare categorical variables. Means were compared using the Student t test. Stepwise logistic regression was used to identify the odds of dying associated with each risk factor. RESULTS: Two hundred and forty patients were included in the study. Between 1990 and 1994 the mean age rose from 35 to 36.9 years, the male/female ratio decreased from 9.8 to 2.0, the non-white proportion increased from 18.5 to 41.3% and the mean time between detection of HIV infection and hospitalization rose from 0.7 to 2.5 years. In addition, length of stay dropped from 31.3 to 25.3 days and the proportion of patients being followed up in the outpatient clinic of the Universitary Hospital increased from 47.8 to 83.3%. Respiratory infections were the main cause of hospitalization (58.0%). Oral candidiasis (27.1%), tuberculosis (18.3%), Pneumocystis carinii pneumonia (15.4%) and toxoplasmic encephalitis (10.4%) were the most frequent opportunistic infections. Multivariate analysis showed that the factors associated with a worse outcome included the length of stay less than or equal to 7 days (Odds Ratio [OR]=3.88; p=0.02) and no outpatient follow-up at the Hospital (OR=3.29; p=0.01). CONCLUSION: Identification of independent risk factors for death may help in the implementation of more efficient interventions directed towards inpatients with HIV/AIDS. OBJETIVO: Estudar os descritores clínico-epidemiológicos da mortalidade em pacientes internados por condições clínicas associadas à infecção pelo HIV. MÉTODO: Estudo retrospectivo de todos os pacientes adultos hospitalizados em 1990, 1992 e 1994 em hospital universitário. Os resultados foram descritos como números absolutos, percentagens e médias, sendo a significância estatística entre as diferenças avaliada pelos testes do qui-quadrado, exato de Fisher ou t de Student, conforme o caso. Um modelo de regressão logística foi elaborado visando a identificar os principais fatores associados ao risco de evolução para o óbito. RESULTADOS: Foram incluídos no estudo 240 pacientes. Entre 1990 e 1994 a idade média dos pacientes aumentou de 35,0 para 36,9 anos, a razão entre os sexos masculino e feminino caiu de 9,8 para 2,0, a proporção de não brancos cresceu de 18,5 para 41,3 e registrou-se um aumento do tempo médio entre a descoberta da infecção pelo HIV e a hospitalização de 0,7 para 2,5 anos. Observou-se a redução do número médio de dias de hospitalização de 31,3 para 25,3 e aumento da proporção de pacientes em acompanhamento ambulatorial de 47,8 para 83,3%. As infecções respiratórias representaram a principal causa de hospitalização (58%) e as infecções oportunistas apresentadas com maior freqüência foram: candidíase oral (27,1%), tuberculose (18,3%), pneumonia por Pneumocystis carinii (15,4%) e neurotoxoplasmose (10,4%). Na análise multivariada, apenas o tempo de hospitalização menor ou igual a 7 dias (Odds Ratio [OR]=3,88; p=0,02) e a ausência de acompanhamento ambulatorial (OR=3,29; p=0,01) mostraram-se associados a um maior risco de evolução para óbito. CONCLUSÃO: O conhecimento dos fatores associados a um risco aumentado de morte pode ser útil na tomada de decisão frente a pacientes hospitalizados com infecção pelo HIV. Universidade de São Paulo. Faculdade de Saúde Pública1998-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/2442010.1590/S0034-89101998000600011Revista de Saúde Pública; Vol. 32 No. 6 (1998); 572-578 Revista de Saúde Pública; Vol. 32 Núm. 6 (1998); 572-578 Revista de Saúde Pública; v. 32 n. 6 (1998); 572-578 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporhttps://www.revistas.usp.br/rsp/article/view/24420/26344Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessThuler, Luiz Claudio SantosHatherly, André LuísGóes, Patrícia NascimentoSilva, Jorge Roberto de Almeida e2012-05-29T17:01:23Zoai:revistas.usp.br:article/24420Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-05-29T17:01:23Revista de Saúde Pública - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Mortality descriptors in HIV inpatients
Infecção pelo HIV: descritores de mortalidade em pacientes hospitalizados
title Mortality descriptors in HIV inpatients
spellingShingle Mortality descriptors in HIV inpatients
Thuler, Luiz Claudio Santos
Síndrome de imunodeficiência adquirida
Tempo de internação
Mortalidade hospitalar
Acquired immunodeficiency syndrome
Lenth of stay
Hospital mortality
title_short Mortality descriptors in HIV inpatients
title_full Mortality descriptors in HIV inpatients
title_fullStr Mortality descriptors in HIV inpatients
title_full_unstemmed Mortality descriptors in HIV inpatients
title_sort Mortality descriptors in HIV inpatients
author Thuler, Luiz Claudio Santos
author_facet Thuler, Luiz Claudio Santos
Hatherly, André Luís
Góes, Patrícia Nascimento
Silva, Jorge Roberto de Almeida e
author_role author
author2 Hatherly, André Luís
Góes, Patrícia Nascimento
Silva, Jorge Roberto de Almeida e
author2_role author
author
author
dc.contributor.author.fl_str_mv Thuler, Luiz Claudio Santos
Hatherly, André Luís
Góes, Patrícia Nascimento
Silva, Jorge Roberto de Almeida e
dc.subject.por.fl_str_mv Síndrome de imunodeficiência adquirida
Tempo de internação
Mortalidade hospitalar
Acquired immunodeficiency syndrome
Lenth of stay
Hospital mortality
topic Síndrome de imunodeficiência adquirida
Tempo de internação
Mortalidade hospitalar
Acquired immunodeficiency syndrome
Lenth of stay
Hospital mortality
description OBJECTIVE: To assess the clinical-epidemiological descriptors of inpatient mortality in persons infected with the human immunodeficiency virus (HIV). METHOD: All adult HIV/AIDS patients hospitalized at a university hospital in 1990, 1992 and 1994 were studied retrospectively. Descriptive statistics for all variables of interest were generated. Chi-square test and Fisher's exact test were performed to compare categorical variables. Means were compared using the Student t test. Stepwise logistic regression was used to identify the odds of dying associated with each risk factor. RESULTS: Two hundred and forty patients were included in the study. Between 1990 and 1994 the mean age rose from 35 to 36.9 years, the male/female ratio decreased from 9.8 to 2.0, the non-white proportion increased from 18.5 to 41.3% and the mean time between detection of HIV infection and hospitalization rose from 0.7 to 2.5 years. In addition, length of stay dropped from 31.3 to 25.3 days and the proportion of patients being followed up in the outpatient clinic of the Universitary Hospital increased from 47.8 to 83.3%. Respiratory infections were the main cause of hospitalization (58.0%). Oral candidiasis (27.1%), tuberculosis (18.3%), Pneumocystis carinii pneumonia (15.4%) and toxoplasmic encephalitis (10.4%) were the most frequent opportunistic infections. Multivariate analysis showed that the factors associated with a worse outcome included the length of stay less than or equal to 7 days (Odds Ratio [OR]=3.88; p=0.02) and no outpatient follow-up at the Hospital (OR=3.29; p=0.01). CONCLUSION: Identification of independent risk factors for death may help in the implementation of more efficient interventions directed towards inpatients with HIV/AIDS.
publishDate 1998
dc.date.none.fl_str_mv 1998-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rsp/article/view/24420
10.1590/S0034-89101998000600011
url https://www.revistas.usp.br/rsp/article/view/24420
identifier_str_mv 10.1590/S0034-89101998000600011
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rsp/article/view/24420/26344
dc.rights.driver.fl_str_mv Copyright (c) 2017 Revista de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2017 Revista de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Saúde Pública
dc.source.none.fl_str_mv Revista de Saúde Pública; Vol. 32 No. 6 (1998); 572-578
Revista de Saúde Pública; Vol. 32 Núm. 6 (1998); 572-578
Revista de Saúde Pública; v. 32 n. 6 (1998); 572-578
1518-8787
0034-8910
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reponame_str Revista de Saúde Pública
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repository.name.fl_str_mv Revista de Saúde Pública - Universidade de São Paulo (USP)
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