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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Survival trends in critically ill HIV-infected patients in the highly active antiretroviral therapy era. | Coquet et al. Critical Care 2010 14 R107 http ccforum.eom content 14 3 R107 RESEARCH Open Access Survival trends in critically ill HIV-infected patients in the highly active antiretroviral therapy era Isaline Coquet 1 Juliette Pavie2 Pierre Palmer3 Francois Barbier1 Stéphane Legriel1 Julien Mayaux1 Jean Michel Molina2 Benoit Schlemmer1 and Elie Azoulay 1 Abstract Introduction The widespread use of highly active antiretroviral therapy ART has reduced HIV-related life-threatening infectious complications. Our objective was to assess whether highly active ART was associated with improved survival in critically ill HIV-infected patients. Methods A retrospective study from 1996 to 2005 was performed in a medical intensive care unit ICU in a university hospital specialized in the management of immunocompromised patients. A total of 284 critically ill HIV-infected patients were included. Differences were sought across four time periods. Risk factors for death were identified by multivariable logistic regression. Results Among the 233 82 patients with known HIV infection before ICU admission 64 were on highly active ART. Annual admissions increased over time with no differences in reasons for admission proportions of patients with newly diagnosed HIV previous opportunistic infection CD4 counts viral load or acute disease severity. ICU and 90-day mortality rates decreased steadily 25 and 37.5 in 1996 to 1997 17.1 and 17.1 in 1998 to 2000 13.2 and 13.2 in 2001 to 2003 and 8.6 in 2004 to 2005. Five factors were independently associated with increased ICU mortality delayed ICU admission odds ratio OR 3.04 95 confidence interval CI 1.29 to 7.17 acute renal failure OR 4.21 95 CI 1.63 to 10.92 hepatic cirrhosis OR 3.78 95 CI 1.21 to 11.84 ICU admission for coma OR 2.73 95 CI 1.16 to 6.46 and severe sepsis OR 3.67 95 CI 1.53 to 8.80 . Admission to the ICU in the most recent period was independently associated with increased survival admission from 2001 to 2003 OR 0.28 95 CI 0.08 .
