Mocroft A, Monforte A d'Arminio, Kirk O, Johnson M A, Friis-Moller N, Banhegyi D, Blaxhult A, Mulcahy F, Gatell J M, Lundgren J D
Royal Free Centre for HIV Medicine, Royal Free and University College Medical School, London, UK.
HIV Med. 2004 Nov;5(6):437-47. doi: 10.1111/j.1468-1293.2004.00250.x.
To describe changes in the proportions of patients admitted to hospital and the duration of admission during the month of March between 1995 and 2003 and to describe the factors related to admission for 9802 patients from EuroSIDA, a pan-European, observational cohort study.
Generalized estimating equations were used to determine changes over time in the proportion of patients admitted and the median duration of admission. Logistic regression was used to determine factors related to admission in March 1995, March 1998 and March 2001.
The proportion of patients admitted during March declined from 7.4% in 1995 to 2.6% in 2003. After adjustment, the estimated reduction in the proportion of patients admitted was 5.5% per year [95% confidence interval (CI) 2.5-8.5%; P=0.0004], a 26% reduction. The median duration of hospital admission declined by 58% from 12 days in 1995 [interquartile range (IQR) 5-19 days] to 5 days in 2003 (IQR 3-12 days), a significant decline of 0.7 days per year after adjustment (95% CI 0.5-0.9 days; P=0.031). Patients with a lower CD4 lymphocyte count, and with an AIDS diagnosis made within the 3 months prior to March, all had increased odds of admission during March 1995, 1998 or 2001. In March 2001, patients whose treatment regimen was changed as a consequence of toxicities had increased odds of admission [odds ratio (OR) 2.34; 95% CI 1.26-4.37; P=0.0074]. In addition, patients who were hepatitis C virus-positive during March 2001 (OR 1.66; 95% CI 1.02-2.68; P=0.041) had increased odds of admission.
There has been a considerable decline in both the proportion of patients admitted to hospital and the median duration of the stay. Patients with hepatitis C had increased odds of admission, but there was little evidence of an increase in admissions among patients taking highly active antiretroviral therapy (HAART) associated with serious adverse events, although longer follow up is required.
描述1995年至2003年3月期间住院患者比例及住院时间的变化，并描述来自泛欧洲观察性队列研究EuroSIDA的9802名患者的入院相关因素。
采用广义估计方程来确定入院患者比例和住院时间中位数随时间的变化。采用逻辑回归来确定1995年3月、1998年3月和2001年3月的入院相关因素。
3月期间入院患者比例从1995年的7.4%降至2003年的2.6%。调整后，估计入院患者比例每年下降5.5%[95%置信区间（CI）2.5 - 8.5%；P = 0.0004]，即下降26%。住院时间中位数从1995年的12天[四分位间距（IQR）5 - 19天]下降58%至2003年的5天（IQR 3 - 12天），调整后每年显著下降0.7天（95% CI 0.5 - 0.9天；P = 0.031）。CD4淋巴细胞计数较低以及在3月前3个月内被诊断为艾滋病的患者，在1995年3月、1998年3月或2001年3月入院的几率均增加。在2001年3月，因毒性反应而改变治疗方案的患者入院几率增加[优势比（OR）2.34；95% CI 1.26 - 4.37；P = 0.0074]。此外，2001年3月丙型肝炎病毒阳性的患者入院几率增加（OR 1.66；95% CI 1.02 - 2.68；P = 0.041）。
住院患者比例和住院时间中位数均有显著下降。丙型肝炎患者入院几率增加，但几乎没有证据表明接受高效抗逆转录病毒治疗（HAART）且伴有严重不良事件的患者入院率增加，不过仍需要更长时间的随访。
