Predictors of Short- and Long-term Survival in HIV-Infected Patients Admitted to the ICU

Predictors of Short- and Long-term Survival in HIV-Infected Patients Admitted to the ICUThe usefulness and efficacy of intensive care can be evaluated based on survival in the short term (in-ICU and in-hospital) and long term. Objective data on the potential benefits of intensive care on the long-term outcome after ICU discharge are stillsparse. It is now agreed that age, physiologic scores reflecting the severity of the acute illness, in-ICU need for invasive or life-supporting procedures, and health status dramatically influence the outcomes of ICU-treated patients. There is also evidence that the prognosis depends on comorbid conditions and on the acute organ failure that led to ICU admission.
Despite recent advances in antiretroviral treatments and in curative and prophylactic regimens for common opportunistic infections, the prognosis of HIV infection remains poor. HIV-related disease, with AIDS as the ultimate manifestation, remains consistently fatal. As with other fatal diseases, the use of intensive care resources in HIV infection raises some ethical and economic issues. Several authors have reported their experience with intensive care for HIV-infected patients. More than two thirds of HIV-infected patients in ICUs were admitted because of respiratory failure, and nearly all of these had Pneumocystis carinii pneumonia (PCP). Few data are available on HIV-infected patients given intensive care for causes other than PCP.
This prospective study was conducted to evaluate the short- and long-term survival of HIV-infected patients admitted to an ICU and to identify clinical and biological markers of prognostic significance. We evaluated the prognostic value of clinical and laboratory test parameters that are readily available on the charts of HIV-infected patients, as well as clinical and laboratory data currently used to assess the prognosis in ICU patients.

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