A multivariate prognostic score for predicting mortality of acquired immunodeficiency syndrome patients with Hypoxemic Respiratory Failure and Pneumocystis Jiroveci Pneumonia
Título del documento: A multivariate prognostic score for predicting mortality of acquired immunodeficiency syndrome patients with Hypoxemic Respiratory Failure and Pneumocystis Jiroveci Pneumonia
Revista: Revista de investigación clínica
Base de datos: PERIÓDICA
Número de sistema: 000454133
ISSN: 0034-8376
Autores: 1
1
2
2
1
Instituciones: 1Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Unidad de Cuidados Intensivos Respiratorios, Ciudad de México. México
2Instituto Tecnológico y de Estudios Superiores de Monterrey, Escuela de Medicina, Ciudad de México. México
Año:
Periodo: Sep-Oct
Volumen: 71
Número: 5
Paginación: 311-320
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés Background Severe hypoxemic respiratory failure (SHRF) due to Pneumocystis jiroveci pneumonia (PJP) in AIDS patients represents the main cause of admission and mortality in respiratory intensive care units (RICUs) in low- and middle-income countries. Objective The objective of this study was to develop a predictive scoring system to estimate the risk of mortality in HIV/AIDS patients with PJP and SHRF. Methods We analyzed data of patients admitted to the RICU between January 2013 and January 2018 with a diagnosis of HIV infection and PJP. Multivariate logistic regression and Kaplan–Meier method were used in data analysis. The RICU and inhospital mortality were 25% and 26%, respectively. Multivariate analysis identified four independent predictors: body mass index, albumin, time to ICU admission, and days of vasopressor support. A predictive scoring system was derived and validated internally. The discrimination was 0.869 (95% confidence interval: 0.821-0.917) and calibration intercept (α) and slope (β) were 0.03 and 0.99, respectively. The sensitivity was 47.2%, specificity was 84.6%, positive predictive value was 89.2%, and negative predictive value was 82.6%. Conclusions This scoring system is a potentially useful tool to assist clinicians, in low- and medium-income countries, in estimating the RICU and inhospital mortality risk in patients with HIV/AIDS and SHRF caused by PJP
Disciplinas: Medicina
Palabras clave: Neumología,
Inmunología,
VIH,
SIDA,
Falla respiratoria hipoxémica severa,
Neumonía,
Pneumocystis jiroveci,
Factores pronósticos,
Mortalidad
Keyword: Pneumology,
Immunology,
HIV,
AIDS,
Severe hypoxemic respiratory failure,
Pneumonia,
Pneumocystis jiroveci,
Prognostic factors,
Mortality
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