Table 1.
Characteristics of the 284 HIV-positive patients admitted to the ICU between 1996 and 2005
| Variable | Survived the ICU (n = 245) | Died in the ICU (n = 39) | Odds ratio (95% confidence interval) | P value |
|---|---|---|---|---|
| Age | 42.6 (36.4 to 48.6) | 41.3(36.1 to 49) | 1 (0.9 to 1) | 0.9 |
| Males | 176 (71.8) | 27(69.2) | 0.9 (0.4 to 1.8) | 0.74 |
| Period of ICU admission | ||||
| 1996 to 1997 | 18 (7.3) | 6 (15.4) | Ref | - |
| 1998 to 2000 | 63 (25.7) | 13 (33.3) | 0.62 (0.21 to 1.86) | 0.39 |
| 2001 to 2003 | 79 (32.2) | 12 (30.8) | 0.46 (0.15 to 1.38) | 0.16 |
| 2004 to 2005 | 85 (34.7) | 8 (20.5) | 0.28 (0.09 to 0.91) | 0.03 |
| Co-morbidities | ||||
| COPD | 12 (4.9) | 3 (7.7) | 1.6 (0.4 to 6.1) | 0.5 |
| Hepatic cirrhosis | 19 (7.8) | 9 (23) | 3.6 (1.5 to 8.6) | 0.005 |
| Chronic C hepatitis infection | 45 (18.4) | 11(28.2) | 1.7 (0.8 to 3.8) | 0.1 |
| Chronic B hepatitis infection | 41 (16.7) | 9 (23.1) | 1.5 (0.7 to 3.4) | 0.3 |
| Chronic renal failure | 18 (7.3) | 1 (2.6) | 0.3 (0.04 to 2.6) | 0.3 |
| Kaposi sarcoma | 23 (9.4) | 9 (23.1) | 2.9 (1.2 to 6.8) | 0.01 |
| Psychiatric disorders | 77 (31.4) | 8 (20.5) | 0.56 (0.25 to 1.3) | 0.2 |
| Homeless | 22 (9) | 4 (10.3) | 1.2 (0.4 to 3.6) | 0.8 |
| HIV-related characteristics | ||||
| Time since HIV diagnosis (months) | 70.5 (4 to 146) | 88 (13 to 149.5) | 1 (0.9 to 1) | 0.7 |
| HIV diagnosis within past 60 days | 51 (21.1) | 5 (14.3) | 0.6 (0.2 to 1.7) | 0.3 |
| CD4+ cell count | 96 (23.5 to 289) | 65 (32 to 287) | 0.9 (0.9 to 1) | 0.5 |
| CD4+ cell count <200 | 162 (66.2) | 27 (68.7) | 1.12 (0.51 to 2.5) | 0.77 |
| Previous opportunistic infections | 121 (49.4) | 18 (46.1) | 0.9 (0.4 to 1.7) | 0.7 |
| Viral load (× 1,000 log10/ml) | 53.8 (0.5 to 252) | 28.1 (0 to 10825) | 1 | 0.2 |
| On HAART at ICU admissiona | 125 (51) | 25 (64.1) | 1.7 (0.8 to 3.4) | 0.13 |
| Viral replication controlled | 58 (46.4) | 10 (43.5) | 0.9 (0.4 to 2.2) | 0.8 |
| Cotrimoxazole prophylaxis | 79 (32.2) | 15 (38.4) | 1.3 (0.6 to 2.6) | 0.4 |
| ICU admission | ||||
| Direct ICU admission | 135 (55.1) | 15 (38.5) | 0.51 (0.25 to 1.02) | 0.05 |
| Hospital to ICU admission (days) | 0 (0 to 2) | 1 (0 to 8) | 1.05/day (1.01 to 1.08) | 0.01 |
| Main reason for ICU admission | ||||
| Acute respiratory failure | 145 (59.2) | 22 (56.4) | 0.9 (0.4 to 1.8) | 0.7 |
| Coma | 71 (28.9) | 20 (51.3) | 2.6 (1.3 to 5.1) | 0.006 |
| Sepsisb | 48 (19.6) | 20 (51.3) | 4.3 (2.1 to 8.7) | 0.0001 |
| Shockc | 34 (13.9) | 25 (64.1) | 11.1 (5.2 to 23.4) | 0.0001 |
| Renal failure | 32 (13.1) | 15 (38.5) | 4.2 (2 to 8.8) | 0.0002 |
| Metabolic abnormalities | 19 (7.8) | 13 (33.3) | 5.9 (2.6 to 13.4) | 0.0001 |
| Liver failure | 9 (3.7) | 14 (35.9) | 14.7 (5.8 to 37.3) | 0.0001 |
| Definite diagnoses | ||||
| Infection | 103 (42) | 26 (66.7) | 2.8 (1.3 to 5.6) | 0.005 |
| Septic shockd | 12 (4.9) | 20 (51.3) | 20.4 (8.7 to 48) | 0.0001 |
| Bacterial pneumonia | 84 (34.3) | 10 (25.6) | 0.7 (0.3 to 1.4) | 0.3 |
| Pneumocystis pneumonia | 50 (20.4) | 3 (7.7) | 0.3 (0.1 to 1.1) | 0.07 |
| Cerebral toxoplasmosis | 15 (6.1) | 2 (2.6) | 0.4 (0.05 to 3.1) | 0.4 |
| Status epilepticus | 19 (7.8) | 3 (7.7) | 1 (0.3 to 3.5) | 0.9 |
| Meningitis | 18 (7.3) | 2 (5.1) | 0.7 (0.1 to 3.1) | 0.6 |
| Cerebral hemorrhage | 4 (1.6) | 5 (12.8) | 8.9 (2.3 to 34.6) | 0.002 |
| Multiple organ failure | 5 (2) | 24 (61.5) | 76.8 (25.7 to 229.7) | 0.0001 |
| Macrophage activation syndrome | 10 (4) | 6(15.4) | 4.27 (1.5 to 12.5) | 0.008 |
| Life-supporting procedures | ||||
| Mechanical ventilation | 86 (35.1) | 38 (97.4) | 70.2 (9.5 to 521) | 0.0001 |
| Renal replacement therapy | 17 (6.4) | 14 (35.9) | 7.5 (3.3 to 17) | 0.0001 |
| Vasopressors | 33 (13.5) | 31 (79.5) | 24.9 (10.5 to 59) | 0.0001 |
| Duration of life support (days) | 0 (0 to 3) | 3 (1 to 7.7) | 1.07 (1.02 to 1.1) | 0.002 |
Data presented as median (interquartile range) or number (percentage). ICU, intensive care unit; COPD, chronic obstructive pulmonary disease; HAART, highly active antiretroviral therapy. aOn HAART at ICU admission for >30 days. bDefined as clinically or microbiologically documented infection with systemic inflammatory response syndrome. cDefined as systolic arterial pressure <80 mmHg despite adequate fluid resuscitation. dDefined as sepsis-induced hypotension persisting despite adequate fluid resuscitation.