Brazilian Journal of Pulmonology

ISSN (on-line): 1806-3756 | ISSN (printed): 1806-3713

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Predictors of mortality among intensive care unit patients coinfected with tuberculosis and HIV

Preditores de mortalidade em pacientes da unidade de terapia intensiva coinfectados por tuberculose e HIV

Marcia Danielle Ferreira1,2,a, Cynthia Pessoa das Neves1,3,b, Alexandra Brito de Souza3,c, Francisco Beraldi-Magalhães1,3,d, Giovanni Battista Migliori4,e, Afrânio Lineu Kritski5,f, Marcelo Cordeiro-Santos1,3,g

J Bras Pneumol.2018;44(2):118-124

Abstract PDF PT PDF EN Portuguese Text

Objective: To identify factors predictive of mortality in patients admitted to the ICU with tuberculosis (TB)/HIV coinfection in the Manaus, Amazon Region. Methods: This was a retrospective cohort study of TB/HIV coinfected patients over 18 years of age who were admitted to an ICU in the city of Manaus, Brazil, between January of 2011 and December of 2014. Sociodemographic, clinical, and laboratory variables were assessed. To identify factors predictive of mortality, we employed a Cox proportional hazards model. Results: During the study period, 120 patients with TB/HIV coinfection were admitted to the ICU. The mean age was 37.0 ± 11.7 years. Of the 120 patients evaluated, 94 (78.3%) died and 62 (66.0%) of those deaths having occurred within the first week after admission. Data on invasive mechanical ventilation (IMV) and ARDS were available for 86 and 67 patients, respectively Of those 86, 75 (87.2%) underwent IMV, and, of those 67, 48 (71.6%) presented with ARDS. The factors found to be independently associated with mortality were IMV (p = 0.002), hypoalbuminemia (p = 0.013), and CD4 count < 200 cells/mm3 (p = 0.002). Conclusions: A high early mortality rate was observed among TB/HIV coinfected ICU patients. The factors predictive of mortality in this population were IMV, hypoalbuminemia, and severe immunosuppression.

 


Keywords: Mycobacterium tuberculosis; Critical care; Respiration, artificial; Acquired immunodeficiency syndrome.

 


 

 


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