Seng R, Mutuon P, Riou J, Duvivier C, Weiss L, Lelievre J D, Meyer L, Vittecoq D, Zak Dit Zbar O, Frenkiel J, Frank-Soltysiak M, Boue F, Rapp C, Sobel A, Brucker G, Goujard C, Salmon D
CESP INSERM, Paris-Sud-University, 94276 Le-Kremlin-Bicêtre cedex, France; Department of Epidemiology and Public Health, AP-HP Bicetre hospital, 94276 Le-Kremlin-Bicêtre cedex, France.
Department of Epidemiology and Public Health, AP-HP Bicetre hospital, 94276 Le-Kremlin-Bicêtre cedex, France.
Rev Epidemiol Sante Publique. 2018 Feb;66(1):7-17. doi: 10.1016/j.respe.2017.08.002. Epub 2017 Dec 10.
In a context of the evolution of severe morbidities in patients living with HIV (PLWH), the aim of this study was to describe reasons for hospitalization and the mode of care for the patients requiring hospitalization.
All admissions (≥24h) of PLWH to 10 hospitals in the south of Paris (COREVIH Ile-de-France Sud) between 1/1/2011 and 12/31/2011 were identified. The hospital database and the file of patients followed in the HIV referral department of each hospital were matched. Detailed clinical and biological data were collected, by returning to the individual medical records, for a random sample (65% of hospitalized patients).
A total of 3013 hospitalizations (1489 patients) were recorded in 2011. The estimated rate of hospitalized patients was about 8% among the 10105 PLWH routinely managed in COREVIH Ile-de-France Sud in 2011. The majority (58.5%) of these hospitalizations occurred in a unit other than the HIV referral unit. Non-AIDS-defining infections were the main reason for admission (16.4%), followed by HIV-related diseases (15.6%), hepatic/gastrointestinal diseases (12.0%), and cardiovascular diseases (10.3%). The median length of stay was 5 days overall (IQR: 2-11), it was longer among patients admitted to a referral HIV care unit than to another ward. HIV infection had been diagnosed >10 years previously in 61.4% of these hospitalized patients. They often had associated comorbidities (coinfection HCV/HVB 40.5%, smoking 45.8%; hypertension 33.4%, dyslipidemia 28.8%, diabetes 14.8%). Subjects over 60 years old accounted for 15% of hospitalized patients, most of them were virologically controlled under HIV treatment, and cardiovascular diseases were their leading reason for admission.
Needs for hospitalization among PLWH remain important, with a wide variety in causes of admission, involving all hospital departments. It is essential to prevent comorbidities to reduce these hospitalizations, and to maintain a link between the management of PLWH, that becomes rightly, increasing ambulatory, and recourse to specialized inpatient services.
在感染人类免疫缺陷病毒（HIV）的患者（PLWH）严重疾病不断演变的背景下，本研究旨在描述住院原因以及需住院治疗患者的护理模式。
确定了2011年1月1日至2011年12月31日期间巴黎南部10家医院（法兰西岛南部HIV协作中心）收治的所有PLWH（住院时间≥24小时）。将医院数据库与每家医院HIV转诊科室随访的患者档案进行匹配。通过查阅个人病历，对随机抽取的样本（65%的住院患者）收集详细的临床和生物学数据。
2011年共记录了3013次住院（涉及1489名患者）。2011年在法兰西岛南部HIV协作中心常规管理的10105名PLWH中，住院患者的估计比例约为8%。这些住院病例中的大多数（58.5%）发生在HIV转诊科室以外的科室。非艾滋病定义性感染是入院的主要原因（16.4%），其次是HIV相关疾病（15.6%）、肝脏/胃肠道疾病（12.0%）和心血管疾病（10.3%）。总体中位住院时间为5天（四分位间距：2 - 11天），入住HIV转诊护理科室的患者比入住其他病房的患者住院时间更长。在这些住院患者中，61.4%在10年多以前就被诊断出感染HIV。他们常伴有合并症（丙型肝炎病毒/乙型肝炎病毒合并感染40.5%，吸烟45.8%；高血压33.4%，血脂异常28.8%，糖尿病14.8%）。60岁以上的患者占住院患者的15%，他们大多数在接受HIV治疗的情况下病毒得到控制，心血管疾病是他们入院的主要原因。
PLWH的住院需求仍然很大，入院原因多种多样，涉及所有医院科室。预防合并症以减少这些住院情况，并在PLWH的管理（其门诊治疗日益增多）与求助于专门的住院服务之间保持联系至关重要。
