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Revista de investigación clínica
versión On-line ISSN 2564-8896versión impresa ISSN 0034-8376
Resumen
HERNANDEZ-CARDENAS, Carmen M. et al. A multivariate prognostic score for predicting mortality of acquired immunodeficiency syndrome patients with Hypoxemic Respiratory Failure and Pneumocystis Jiroveci Pneumonia. Rev. invest. clín. [online]. 2019, vol.71, n.5, pp.311-320. Epub 09-Abr-2021. ISSN 2564-8896. https://doi.org/10.24875/ric.19002957.
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 KaplanMeier 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.
Palabras llave : Intensive care units; Severe hypoxemic respiratory failure; Pneumocystis jiroveci pneumonia; Human immunodeficiency virus; Acquired immunodeficiency syndrome; Prognostic factors; Mortality.