Abdourahimi D, Yehadji D, Briskin E, Khine E M, Arias C, André K S, Mukebela F K, Ndayisenga L, Isaakidis P, Casas E C, Steele S J, Sacko F B, Foromo G
Médecins Sans Frontières (MSF), Conakry, Guinée.
Médecins Sans Frontières, Luxembourg Operational Research (LuxOR) unit, Luxembourg City, Luxembourg.
Public Health Action. 2023 Aug 1;13(2 Suppl 1):19-24. doi: 10.5588/pha.23.0009.
A unit supported by Médecins Sans Frontières (MSF) cares for patients with advanced HIV at Donka National Hospital, Conakry, Guinea.
To determine the factors associated with the occurrence of death in patients hospitalised in the unit between 2017 and 2021.
This was a retrospective analysis of routine data from patients hospitalised with advanced HIV.
A total of 3,718 patients were included, with a median age of 40 years (IQR 33-51), of whom 2,241 (60.3%) were women. The mean mortality rate was 33.6% ( = 1,240), down from 40% in 2017 to 29% in 2021, but this was not statistically significant. The period most at risk of death was the first 25 days of hospitalisation. Among these patients, TB (43.8%) and toxoplasmosis (11.4%) were the most frequent diagnoses. After multivariate analysis using Cox regression, the factors associated with death were age 25-49 years (adjusted hazard ratio [aHR] 1.60; = 0.002) or ≥50 years (aHR 1.80; < 0.001), the presence of respiratory (aHR 1.23; = 0.001) or abdominal symptoms (aHR 1.26; < 0.001) and readmission (aHR 0.54; < 0.001).
Patients aged 25-49 years or older, or those presenting with respiratory or abdominal signs require increased surveillance, as they are at the greatest risk of dying from the disease, especially during the first 25 days of hospitalisation.
由无国界医生组织（MSF）支持的一个医疗单位在几内亚科纳克里的东卡国家医院为晚期艾滋病患者提供护理。
确定2017年至2021年期间在该医疗单位住院的患者中与死亡发生相关的因素。
这是一项对晚期艾滋病住院患者常规数据的回顾性分析。
共纳入3718例患者，中位年龄为40岁（四分位间距33 - 51岁），其中2241例（60.3%）为女性。平均死亡率为33.6%（n = 1240），从2017年的40%降至2021年的29%，但差异无统计学意义。死亡风险最高的时期是住院的前25天。在这些患者中，结核病（43.8%）和弓形虫病（11.4%）是最常见的诊断。使用Cox回归进行多因素分析后，与死亡相关的因素包括年龄25 - 49岁（调整后风险比[aHR] 1.60；P = 0.002）或≥50岁（aHR 1.80；P < 0.001）、存在呼吸道症状（aHR 1.23；P = 0.001）或腹部症状（aHR 1.26；P < 0.001）以及再次入院（aHR 0.54；P < 0.001）。
年龄在25 - 49岁及以上的患者，或出现呼吸道或腹部症状的患者需要加强监测，因为他们死于该疾病的风险最高，尤其是在住院的前25天。
