Septic shock in patients with the acquired immunodeficiency syndrome.
Intensive Care Med
; 23(10): 1018-23, 1997 Oct.
Article
in En
| MEDLINE
| ID: mdl-9407236
ABSTRACT
OBJECTIVE:
To evaluate the prognosis of patients with septic shock admitted to an intensive care unit (ICU), according to their HIV serostatus.DESIGN:
Retrospective study.SETTING:
Medical ICU of a university hospital. PATIENTS 76 patients with septic shock admitted to the same ICU, of whom 28 were HIV positive and 48 were HIV negative. MEASUREMENTS ANDRESULTS:
Severity scores, number and type of organ failures, and survival rates were assessed in the two groups of patients. Glasgow Coma Scale and general severity scores [Acute Physiology and Chronic Health Evaluation II and Simplified Acute Physiology Score (SAPS)] were significantly worse in HIV-infected patients. The total number of organ failures was also higher in the HIV-positive group 3.7 +/- 0.2 vs 3.1 +/- 0.2 in the HIV-negative group (p < 0.001). On day 28, 21 (46%) HIV-negative patients were dead compared to 26 (93%) patients in the HIV-positive group (p < 0.001). In the multivariate analysis, HIV infection was an independent risk factor for mortality, as were the SAPS score, use of mechanical ventilation, and the McCabe score.CONCLUSIONS:
This study reports a considerable excess mortality in HIV-infected patients with septic shock. Although severity of illness was clearly much more pronounced in HIV-positive patients, retroviral infection was independently associated with death. Improving survival in HIV-positive patients with septic shock may require earlier diagnosis and treatment of the causative infection.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Shock, Septic
/
AIDS-Related Opportunistic Infections
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Intensive Care Med
Year:
1997
Type:
Article
Affiliation country:
France