Bakewell, N;
Kanitkar, T;
Dissanayake, O;
Symonds, M;
Rimmer, S;
Adlakha, A;
Lipman, MC;
... Sabin, CA; + view all
(2024)
Comparing short-term mortality between people
with and without HIV admitted to the intensive
care unit: a single-centre matched cohort study
(2000 to 2019).
HIV Medicine
10.1111/hiv.13737.
(In press).
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Abstract
Objectives: The survival rate of people with HIV admitted to intensive care units (ICUs) is approaching that of people without HIV. We conducted a matched-cohort study of people with and without HIV admitted to ICU at a large hospital to compare short-term mortality, during 2000–2019.// Methods: People with HIV were matched to people without HIV (1:2) on age, sex, admission year and Acute Physiology and Chronic Health Evaluation (APACHE)-II score. Applying logistic regression models fitted using independence estimating equations, we describe population-averaged associations of HIV with short-term (in-ICU, in-hospital) mortality during a patient's first admission to ICU, and explore whether these varied by year.// Results: A total of 177 people with HIV were matched to 354 people without HIV (71.2% vs. 71.2% male; median age: 47 vs. 48 years, median APACHE-II: 18 vs. 17, median admission year: 2013 vs. 2013). Among people with HIV, 73.4% were on antiretroviral therapy, 51.2% had HIV-RNA ≤50 copies/mL and median CD4 T-cell count was 132 cells/μ L. People with HIV had higher in-ICU (24.3% vs. 15.3%) and in-hospital (31.6% vs. 20.1%) mortality. People with HIV had 1.69-fold higher odds (95% confidence interval: 1.03–2.76) of in-ICU mortality and 1.86 (1.19–2.91) higher odds of in-hospital mortality than people without HIV, adjusted for age, sex, year and APACHE-II. There was no evidence that these associations varied by year (p-interaction-in-ICU = 0.90; p-interaction-in-hospital = 0.46).// Conclusions: Our findings suggest that although outcomes have improved over time, people with HIV continue to have higher short-term in-ICU and in-hospital mortality following ICU admission compared with people without HIV with similar characteristics.
| Type: | Article |
|---|---|
| Title: | Comparing short-term mortality between people with and without HIV admitted to the intensive care unit: a single-centre matched cohort study (2000 to 2019) |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/hiv.13737 |
| Publisher version: | https://doi.org/10.1111/hiv.13737 |
| Language: | English |
| Additional information: | © The Author(s), 2024. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/ |
| Keywords: | HIV, ICU, hospital, intensive care, matched cohort study, mortality |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10200648 |
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