Foo H, Clezy K, Post J J
Department of Infectious Diseases, Prince of Wales Hospital, Sydney, Australia.
Int J STD AIDS. 2012 Jun;23(6):e4-8. doi: 10.1258/ijsa.2009.009341.
Long-term outcomes of HIV-infected patients admitted to the intensive care unit (ICU) since the advent of combination antiretroviral therapy (cART) have not been well described. We reviewed the long-term outcomes and clinical follow-up of HIV-infected patients admitted to the Prince of Wales Hospital ICU between 1999 and 2005 by a retrospective medical record review. Mortality was assessed in the ICU, in hospital and in the long-term. Twenty-four HIV-infected male patients underwent 26 ICU admissions. Their ICU and in-hospital mortalities were 33% and 46%, respectively. Higher APACHE (acute physiology and chronic health evaluation) II scores (median 27 versus 12, P < 0.001), lower CD4 cell counts (median 45 versus 335 cells/μL, P = 0.041) and longer hospitalization times prior to ICU admission (median 4 versus 1 day, P = 0.02) were significantly associated with in-hospital mortality. We found 85% of the subjects who survived hospital admission were still alive at a median of 41 months (4 months to 5 years) of follow-up, all of who were functionally independent. HIV-infected patients who survived ICU admission at our institution had good long-term outcomes in the cART era.
自联合抗逆转录病毒疗法（cART）问世以来，入住重症监护病房（ICU）的HIV感染患者的长期预后尚未得到充分描述。我们通过回顾性病历审查，对1999年至2005年间入住威尔士亲王医院ICU的HIV感染患者的长期预后和临床随访情况进行了评估。评估了患者在ICU、住院期间及长期的死亡率。24例HIV感染男性患者共入住ICU 26次。他们在ICU和住院期间的死亡率分别为33%和46%。较高的急性生理与慢性健康状况评分系统（APACHE）II评分（中位数27分对12分，P<0.001）、较低的CD4细胞计数（中位数45个对335个/μL，P = 0.041）以及入住ICU前较长的住院时间（中位数4天对1天，P = 0.02）与住院死亡率显著相关。我们发现，85%存活出院的患者在中位随访41个月（4个月至5年）时仍存活，且全部功能独立。在我们机构，在cART时代存活于ICU的HIV感染患者有良好的长期预后。
