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Risk factors and clinical characteristics associated with hospitalization for community-acquired bacterial pneumonia in HIV-positive patients according to the presence of liver cirrhosis
- Publication Year :
- 2009
- Publisher :
- URBAN & VOGEL, 2009.
-
Abstract
- Background: Community-acquired bacterial pneumonia (CABP) represents an important cause of morbidity and mortality for cirrhotic and HIV-infected patients, respectively. However, little is known on CABP in HIV-positive patients with cirrhosis. A study was performed to describev the clinical features and factors predictive of mortality and prolonged hospitalization in cirrhotic HIV-infected patients with a diagnosis of CABP. Methods: Demographic and clinical characteristics of cirrhotic HIV-positive subjects, hospitalized for CABP in our department from June 2000 to December 2006, were compared with those of non-cirrhotic HIV-infected patients with the same diagnosis hospitalized from June 2000 to November 2001. Variables with p < 0.10 in univariate analysis were tested for their predictive value for mortality and length of hospitalization with uni- and multivariate logistic regression analysis. Results: Twenty-nine cirrhotic and 73 non-cirrhotic HIV-positive patients with CABP were compared. Age and alcohol abusewere significantly higher in cirrhotics. At hospital admission, cirrhotic patients had more frequently mental status alterations (7.26 [2.21-23.82], p = 0.001) and milder symptoms and signs (temperature > 37.5 C: 0.27 [0.10-0.75], p = 0.01; respiratory rate > 20: 0.34 [0.13-0.92], p = 0.033; systemic inflammatory response syndrome (SIRS): 0.39 [0.16-0.95], p = 0.038). Adjusting for age, cirrhosis was associated with a higher mortality (5.96 [1.05-33.57]; p = 0.043). Adjusting for age, gender, and concomitant antiretroviral treatment, cirrhosis was also associated with a prolonged hospitalization (> 7 days: 9.30 1.84-46.82]; p = 0.007). Conclusions: The diagnosis of CABP can be difficult in cirrhotic HIV-positive patients because clinical presentation is milder. However, CABP needs to be promptly recognized because mortality is higher in these patients. © 2008 Springer.
- Subjects :
- Liver Cirrhosis
Microbiology (medical)
Adult
Male
medicine.medical_specialty
Cirrhosis
Respiratory rate
Liver Cirrhosi
HIV Infections
Logistic regression
Gastroenterology
Spontaneous bacterial peritonitis
Risk Factors
Internal medicine
medicine
Pneumonia, Bacterial
Humans
Community-Acquired Infection
HIV Infection
Intensive care medicine
Univariate analysis
business.industry
Bacterial pneumonia
General Medicine
Length of Stay
Middle Aged
medicine.disease
Community-Acquired Infections
Systemic inflammatory response syndrome
Hospitalization
Infectious Diseases
Concomitant
Female
business
Human
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....926f0edbe9d7a823867d23d3759b7502