Clinical Characteristics and Short-Term Outcomes of HIV Patients Admitted to an African Intensive Care Unit

Abstract EN

Purpose.

In high-income countries, improved survival has been documented among intensive care unit (ICU) patients infected with human immune deficiency virus (HIV).

There are no data from low-income country ICUs.

We sought to identify clinical characteristics and survival outcomes among HIV patients in a low-income country ICU.

Materials and Methods.

A retrospective cohort study of HIV infected patients admitted to a university teaching hospital ICU in Uganda.

Medical records were reviewed.

Primary outcome was survival to hospital discharge.

Statistical significance was predetermined in reference to P<0.05.

Results.

There were 101 HIV patients.

Average length of ICU stay was 4 days and ICU mortality was 57%.

Mortality in non-HIV patients was 28%.

Commonest admission diagnoses were Acute Respiratory Distress Syndrome (ARDS) (58.4%), multiorgan failure (20.8%), and sepsis (20.8%).

The mean Acute Physiologic and Chronic Health Evaluation (APACHE II) score was 24.

At multivariate analysis, APACHE II (OR 1.24 (95% CI: 1.1–1.4, P=0.01)), mechanical ventilation (OR 1.14 (95% CI: 0.09–0.76, P=0.01)), and ARDS (OR 4.5 (95% CI: 1.07–16.7, P=0.04)) had a statistically significant association with mortality.

Conclusion.

ICU mortality of HIV patients is higher than in higher income settings and the non-HIV population.

ARDS, APACHE II, and need for mechanical ventilation are significantly associated with mortality.