Lau R K, Pinching A J
Department of Immunology, St Mary's Hospital Medical School, London, UK.
Int J STD AIDS. 1991 Mar-Apr;2(2):97-101. doi: 10.1177/095646249100200203.
To assess the clinical and laboratory workload arising from human immunodeficiency virus (HIV)-related inpatient admissions in a London teaching hospital, a 10-month retrospective audit was performed of the casenotes of all HIV-infected inpatients admitted under the care of one consultant physician. During this period, 84 inpatients were identified who generated 371 admissions, of whom 71 (84.5%) had acquired immunodeficiency syndrome (AIDS). Over two-thirds of admissions were essentially day cases, attributed to blood transfusions, antimicrobial and tumour, chemotherapy, and minor surgery; with blood transfusions alone accounting for 43% of all admissions. Pulmonary infections (pyogenic and cell-mediated opportunist) accounted for 46 (12%) of admissions, with Pneumocystis carinii pneumonia second only to blood transfusions in caseload prevalence score (see below). Neurological complications of AIDS were associated with the longest admissions. Laboratory-based investigations were heavily utilized by AIDS inpatients, particularly bacteriological services. Choice of radiological investigation correlated with the anatomical site of disease presentation: plain radiology for chest symptoms, ultrasound for abdominal symptoms and computerized tomography (CT scanning) for neurological presentations. Drug-induced anaemia accounted for a substantial number of HIV-related admissions for red cell transfusions, which together with the disproportionate workload from daycase-type admissions, might be better handled in lower dependency day wards.
为评估伦敦一家教学医院因人类免疫缺陷病毒（HIV）相关住院患者入院所产生的临床和实验室工作量，对一位会诊医师负责治疗的所有HIV感染住院患者的病历进行了为期10个月的回顾性审计。在此期间，共识别出84名住院患者，产生了371次入院记录，其中71名（84.5%）患有获得性免疫缺陷综合征（AIDS）。超过三分之二的入院患者本质上属于日间病例，原因是输血、抗菌及肿瘤化疗以及小型手术；仅输血就占所有入院记录的43%。肺部感染（化脓性和细胞介导的机会性感染）占入院记录的46次（12%），卡氏肺孢子虫肺炎在病例负荷患病率评分中仅次于输血（见下文）。AIDS的神经系统并发症与最长住院时间相关。AIDS住院患者大量使用了基于实验室的检查，尤其是细菌学检查服务。放射学检查的选择与疾病表现的解剖部位相关：胸部症状采用普通放射学检查，腹部症状采用超声检查，神经系统表现采用计算机断层扫描（CT扫描）。药物性贫血占HIV相关红细胞输血入院记录的很大一部分，连同日间病例型入院记录不成比例的工作量，可能在较低护理级别的日间病房能得到更好的处理。
