From the Departments of Cardiology, Infectious Diseases, Clinical Research, and Internal Medicine, Creighton University School of Medicine, Omaha, Nebraska.
South Med J. 2022 Jul;115(7):429-434. doi: 10.14423/SMJ.0000000000001416.
People with human immunodeficiency virus (HIV) are at an increased risk of developing cardiovascular diseases. Hypertensive emergency (HTNE), a complication of hypertension with potentially serious health implications, has high healthcare utilization. We attempted to determine the association between HIV status and risk for 30-day readmission after index hospitalization for HTNE.
We used the Nationwide Readmissions Database to identify all of the admissions during 2010-2017 with a primary discharge diagnosis of HTNE. Admissions were stratified by HIV status and comparisons were made with the χ test. We investigated predictors of all-cause 30-day readmission via multivariable logistic regression.
A total of 612,854 hospitalizations with a primary discharge diagnosis of HTNE were identified, and 4115 (0.7%) were HIV positive. There was a total of 43,937 (7.16%) 30-day readmissions, and the rate was higher in regard to positive HIV status (29.8% vs 15.0%; < 0.001). Renal failure was the most frequent reason for HIV readmissions and the second most frequent reason for non-HIV readmissions (15.6% vs 10.3%; < 0.001). In contrast, heart failure was the most frequent reason for non-HIV readmissions and the second most frequent reason for HIV readmissions (10.3% vs 11.9%; = 0.234). There was a higher median cost for HIV readmissions in comparison to non-HIV readmissions ($7660 vs $7490; < 0.001). Finally, HIV was attributed to 40.6% increased odds of readmission after adjusting for pertinent clinical and demographic factors ( < 0.001).
HIV-positive status is associated with an increased risk for 30-day readmission after index hospitalization for HTNE.
人类免疫缺陷病毒（HIV）感染者发生心血管疾病的风险增加。高血压急症（HTNE）是高血压的一种并发症，可能对健康产生严重影响，其医疗保健利用率很高。我们试图确定 HIV 状态与 HTNE 指数住院后 30 天内再入院风险之间的关系。
我们使用全国再入院数据库确定了 2010 年至 2017 年期间所有主要出院诊断为 HTNE 的入院病例。将入院病例按 HIV 状态分层，并通过 χ 检验进行比较。我们通过多变量逻辑回归调查了所有原因 30 天再入院的预测因素。
共确定了 612854 例主要出院诊断为 HTNE 的住院病例，其中 4115 例（0.7%）HIV 阳性。共有 43937 例（7.16%）30 天再入院，HIV 阳性率更高（29.8%比 15.0%；<0.001）。肾衰竭是 HIV 再入院的最常见原因，也是非 HIV 再入院的第二常见原因（15.6%比 10.3%；<0.001）。相比之下，心力衰竭是非 HIV 再入院的最常见原因，也是 HIV 再入院的第二常见原因（10.3%比 11.9%；=0.234）。与非 HIV 再入院相比，HIV 再入院的中位数费用更高（7660 美元比 7490 美元；<0.001）。最后，在调整了相关临床和人口统计学因素后，HIV 导致再入院的可能性增加了 40.6%（<0.001）。
在因 HTNE 指数住院后，HIV 阳性与 30 天内再入院的风险增加相关。
