A multivariate prognostic score for predicting mortality of acquired immunodeficiency syndrome patients with Hypoxemic Respiratory Failure and Pneumocystis Jiroveci Pneumonia
Rev. invest. clín
; Rev. invest. clín;71(5): 311-320, Sep.-Oct. 2019. tab, graf
Article
em En
| LILACS
| ID: biblio-1289701
Biblioteca responsável:
BR1.1
ABSTRACT
Background Severe hypoxemic respiratory failure (SHRF) due to Pneumocystis jiroveci pneumonia (PJP) in AIDS patients represents the main cause of admission and mortality in respiratory intensive care units (RICUs) in low- and middle-income countries. Objective The objective of this study was to develop a predictive scoring system to estimate the risk of mortality in HIV/AIDS patients with PJP and SHRF. Methods We analyzed data of patients admitted to the RICU between January 2013 and January 2018 with a diagnosis of HIV infection and PJP. Multivariate logistic regression and KaplanMeier method were used in data analysis. The RICU and inhospital mortality were 25% and 26%, respectively. Multivariate analysis identified four independent predictors body mass index, albumin, time to ICU admission, and days of vasopressor support. A predictive scoring system was derived and validated internally. The discrimination was 0.869 (95% confidence interval 0.821-0.917) and calibration intercept (α) and slope (β) were 0.03 and 0.99, respectively. The sensitivity was 47.2%, specificity was 84.6%, positive predictive value was 89.2%, and negative predictive value was 82.6%. Conclusions This scoring system is a potentially useful tool to assist clinicians, in low- and medium-income countries, in estimating the RICU and inhospital mortality risk in patients with HIV/AIDS and SHRF caused by PJP.
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Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Assunto principal:
Pneumonia por Pneumocystis
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Insuficiência Respiratória
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Infecções por HIV
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Síndrome da Imunodeficiência Adquirida
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
Rev. invest. clín
Assunto da revista:
MEDICINA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
México
País de publicação:
México