Table 3.
Associations With Mortality
| 3A. Univariable Associations | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Variable | Category | Data, No. (%) | No. (%) | Mortality 2 wk, % (No.) |
HR (95% CI) | P Value | Mortality 10 wk, % (No.) |
HR (95% CI) | P Value | Mortality 1 y, % (No.) |
HR (95% CI) | P Value |
| Age | <50 y | 234 (99) | 213 (91) | 23 (49) | 1 | .05 | 47 (95) | 1 | <.01 | 61 (121) | 1 | <0.01 |
| ≥50 y | 21 (9) | 45 (9) | 2.02 (1.0–4.1) | 75 (15) | 2.18 (1.3–3.8) | 95 (19) | 2.53 (1.6–4.1) | |||||
| Sex | Male | 236 (100) | 163 (69) | 30 (48) | 1 | .04 | 53 (82) | 1 | .12 | 64 (96) | 1 | 0.75 |
| Female | 73 (31) | 17 (12) | 0.52 (0.3–1.0) | 43 (30) | 0.72 (0.5–1.8) | 67 (46) | 0.94 (0.7–1.3) | |||||
| Mental status | GCS = 15 | 155 (66) | 93 (60) | 20 (18) | 1 | <.01 | 46 (39) | 1 | .04 | 63 (52) | 1 | 0.02 |
| GCS < 15 | 62 (40) | 39 (24) | 2.35 (1.3–4.3) | 53 (32) | 1.64 (1.0–2.6) | 66 (90) | 1.64 (1.1–2.5) | |||||
| Concurrent TB | No | 151 (65) | 138 (91) | 26 (36) | 1 | .19 | 50 (64) | 1 | .25 | 66 (83) | 1 | 0.19 |
| Yes | 13 (9) | 46 (6) | 1.7 (0.7–4.2) | 54 (7) | 1.54 (0.74–3.2) | 69 (9) | 1.55 (0.8–3.0) | |||||
| ART status | No ART | 181 (77) | 100 (55) | 26 (26) | 1 | .77 | 46 (43) | 1 | .15 | 66 (59) | 1 | 0.10 |
| On ART | 81 (45) | 28 (23) | 1.09 (0.6–1.9) | 55 (43) | 1.36 (0.9–2.1) | 66 (51) | 1.37 (0.9–2.0) | |||||
| CD4 category | Per 50 cells/µL increase | 192 (81) | 192 | — | 0.93 (0.8–1.1) | .51 | — | 0.86 (0.7–1.0) | .08 | — | 0.87 (0.8–1.0) | 0.06 |
| Hemoglobin | ≥7.5 g/dL | 215 (91) | 198 (92) | 25 (49) | 1 | .13 | 49 (93) | 1 | .03 | 63 (119) | 1 | 0.09 |
| <7.5 g/dL | 17 (8) | 44 (7) | 1.84 (0.8–4.1) | 73 (11) | 1.99 (1.1–3.6) | 73 (11) | 1.68 (0.9–3.1) | |||||
| White blood cell count | ≤109/L | 215 (91) | 193 (90) | 24 (46) | 1 | .01 | 49 (90) | 1 | .03 | 64 (115) | 1 | 0.12 |
| >109/L | 22 (10) | 45 (10) | 2.44 (1.2–4.8) | 64 (14) | 1.87 (1.1–3.2) | 68 (15) | 1.52 (0.9–2.6) | |||||
| Creatinine | ≤110 µmol/L | 201 (85) | 181 (90) | 23 (41) | 1 | <.01 | 49 (84) | 1 | <.01 | 64 (108) | 1 | <0.01 |
| >110 µmol/L | 20 (10) | 50 (10) | 2.60 (1.3–5.2) | 79 (15) | 2.48 (1.5–4.2) | 84 (16) | 2.30 (1.4–3.8) | |||||
| Sodium | ≥125 mmol/L | 198 (84) | 166 (84) | 23 (38) | 1 | .03 | 48 (76) | 1 | .03 | 63 (97) | 1 | 0.01 |
| <125 mmol/L | 32 (16) | 44 (14) | 1.99 (1.1–3.7) | 66 (21) | 1.69 (1.0–2.7) | 77 (24) | 1.76 (1.1–2.7) | |||||
| CSF OP | <30 cmH2O | 94 (40) | 27 (29) | 30 (8) | 1 | .98 | 54 (14) | 1 | .95 | 72 (18) | 1 | 0.98 |
| ≥30 cmH2O | 67 (71) | 30 (20) | 1.01 (0.4–2.3) | 54 (34) | 1.01 (0.5–1.9) | 68 (42) | 0.99 (0.6–1.8) | |||||
| CSF WCC | ≥20 cells/µL | 236 (100) | 95 (40) | 19 (18) | 1 | .05 | 39 (34) | 1 | <.01 | 62 (52) | 1 | 0.08 |
| <20 cells/µL | 141 (60) | 30 (42) | 1.73 (1.0–3.0) | 57 (78) | 1.80 (1.2–2.7) | 67 (90) | 1.36 (1.0–1.9) | |||||
| Time to first AmB-d dose | 0 d | 157 (67) | 17 (11) | 17 (3) | 1 | .63 | 29 (5) | 1 | .29 | 53 (8) | 1 | 0.34 |
| 1 d | 56 (36) | 21 (12) | 1.18 (0.4–4.2) | 44 (24) | 1.83 (0.6–5.3) | 55 (30) | 1.24 (0.5–2.8) | |||||
| 2+ | 84 (53) | 22 (18) | 1.32 (0.4–4.5) | 44 (34) | 1.93 (0.7–5.5) | 65 (49) | 1.42 (0.6–3.2) | |||||
| Missed AmB-d dosesa | 0 | 158 (67) | 74 (47) | 11 (8) | 1 | <.01 | 31 (20) | 1 | <.01 | 49 (31) | 1 | <0.01 |
| 1–2 | 50 (32) | 28 (14) | 2.92 (1.2–7.0) | 48 (24) | 2.06 (1.1–3.8) | 61 (30) | 1.97 (1.1–3.4) | |||||
| 3+ | 34 (21) | 32 (11) | 3.67 (1.5–9.1) | 56 (19) | 2.71 (1.4–5.1) | 79 (26) | 2.99 (1.7–5.2) | |||||
| 3B. Multivariable Associations | ||||||||||||
| Variable | Category | 2-wk Mortality-Adjusted HR | P Value | 10-wk Mortality-Adjusted HR | P Value | 1-y Mortality-Adjusted HR | P Value | |||||
| Age | <50 y | 1 (base) | .05 | 1 (base) | .03 | 1 (base) | 0.04 | |||||
| ≥50 y | 2.82 (1.0–8.0) | 3.34 (1.1–9.7) | 2.43 (1.0–5.6) | |||||||||
| Mental status | GCS = 15 | 1 (base) | <.01 | 1 (base) | .02 | 1 (base) | 0.03 | |||||
| GCS < 15 | 2.83 (1.4–5.6) | 2.02 (1.1–3.7) | 1.66 (1.0–2.6) | |||||||||
| 3B. Multivariable Associations | ||||||||||||
| Variable | Category | 2-wk Mortality-Adjusted HR | P Value | 10-wk Mortality-Adjusted HR | P Value | 1-y Mortality-Adjusted HR | P Value | |||||
| ART status | No ART | — | — | 1 (base) | <.01 | 1 (base) | <0.01 | |||||
| On ART | — | 2.16 (1.2–3.9) | 1.88 (1.2–3.0) | |||||||||
| CD4 category | Per 50 cells/µL increase | — | — | 0.83 (0.7–1.1) | .07 | — | — | |||||
| White blood cell count | ≤109/L | 1 (base) | <.01 | 1 (base) | .04 | — | — | |||||
| >109/L | 4.23 (1.8–9.9) | 2.47 (1.1–5.8) | — | |||||||||
| Sodium | ≥125 mmol/L | 1 (base) | .05 | 1 (base) | .01 | 1 (base) | <0.01 | |||||
| <125 mmol/L | 2.24 (1.0–4.9) | 2.79 (1.3–6.2) | 2.74 (1.5–5.0) | |||||||||
| CSF WCC | ≥20 cells/µL | 1 (base) | .02 | — | — | — | — | |||||
| <20 cells/µL | 2.39 (1.1–5.0) | — | — | |||||||||
Abbreviations: AmB-d, amphotericin B deoxycholate; ART, antiretroviral therapy; CI, confidence interval; CSF, cerebrospinal fluid; GCS, Glasgow Coma Scale score; HR, hazard ratio; OP, opening pressure; WCC, white cell count.
aWhen restricted to individuals who did not develop either Grade 3 anemia, hypokalemia, or renal impairment during amphotericin B treatment, the hazard ratios were 7.30 (95% CI, 0.9–60.0) at 2 weeks, 4.55 (95% CI, 1.3–16.3) at 10 weeks, and 2.77 (95% CI, 1.1–7.3) at 1 year.