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.