Khouli Hassan, Afrasiabi Ardavan, Shibli Muhamad, Hajal Rizan, Barrett C Redington, Homel Peter
St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York 10019, USA.
J Intensive Care Med. 2005 Nov-Dec;20(6):327-33. doi: 10.1177/0885066605281087.
The purpose of this study was to determine the effect of prior use of highly active antiretroviral therapy (HAART) on outcome of human immunodeficiency virus (HIV)- patients admitted to intensive care units (ICUs). This study was a retrospective chart review of 242 HIV-infected patients who required 259 consecutive admissions to a university-affiliated hospital ICU during a 3-year period. Patient demographics, CD4 count, admission diagnosis, prior HAART, Pneumocystis jiroveci prophylaxis, length of stay, and ICU and hospital mortality were determined. Overall hospital mortality was 39%. Comparing patients who had received HAART before an ICU admission to those who had not, we found no difference between ICU or hospital mortality, need of mechanical ventilation, ICU and hospital length of stay, and incidence of P jiroveci. Pulmonary diagnosis was the most frequent ICU admission diagnosis (30%). Logistic regression analysis showed HIV-related illness and mechanical ventilation were significant independent predictors of increased hospital mortality.
本研究的目的是确定既往使用高效抗逆转录病毒疗法（HAART）对入住重症监护病房（ICU）的人类免疫缺陷病毒（HIV）患者预后的影响。本研究是一项回顾性图表审查，涉及242例HIV感染患者，他们在3年期间连续259次入住一所大学附属医院的ICU。确定了患者的人口统计学特征、CD4细胞计数、入院诊断、既往HAART治疗情况、耶氏肺孢子菌预防情况、住院时间以及ICU和医院死亡率。总体医院死亡率为39%。比较ICU入院前接受过HAART治疗的患者和未接受过HAART治疗的患者，我们发现ICU或医院死亡率、机械通气需求、ICU和医院住院时间以及耶氏肺孢子菌感染发生率之间没有差异。肺部诊断是最常见的ICU入院诊断（30%）。逻辑回归分析显示，与HIV相关的疾病和机械通气是医院死亡率增加的显著独立预测因素。
