Amjad Kanj1, Bilal Samhouri1, Nadine Abdallah2, Omar Chehab3, Misbah Baqir4. 1. Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN. 2. Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN. 3. Department of Medicine, Detroit Medical Center/Wayne State University School of Medicine, Detroit, MI. 4. Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN. Electronic address: Baqir.Misbah@mayo.edu.
Abstract
OBJECTIVE: To assess host factors in pneumocystis jirovecii pneumonia (PCP)-related hospitalizations and compare outcomes between HIV and non-HIV patients. METHODS: Using the National Inpatient Sample database, we identified 3384 hospitalizations with PCP (International Classification of Diseases, Ninth Revision, Clinical Modification code: 136.3) as the primary discharge diagnosis from 2005 to 2014. We evaluated hospitalizations for the following host factors: HIV, malignancies, organ transplantation, rheumatologic diseases, and vasculitides. We compared the prevalence of individual host factors among PCP hospitalizations over time, and compared intervention rates and outcomes between HIV and non-HIV patients with PCP. RESULTS: Among all hospitalizations for PCP, malignancy was the most prevalent host factor (46.0%, n=1559), followed by HIV (17.8%, n=604); 60.7% (n=946) of malignancies were hematologic. The prevalence of HIV among hospitalizations for PCP decreased from 25.1% in 2005 to 9.2% in 2014 (P<.001), whereas the prevalence of non-HIV immunocompromising conditions increased. Compared with HIV patients, PCP patients without HIV had higher rates of bronchoscopy (52.3% vs 26.7%, P<.001) and endotracheal intubation (17.0% vs 7.9%, P<.001), prolonged hospitalizations (11.5 vs 8.7 days, P<.001), higher hospitalization costs (86.8 vs 48.2×103 USD, P<.001) and increased in-hospital mortality (16.0% vs 5.0%, P<.001). After adjusting for age, sex, and smoking status, there was no difference in mortality between non-HIV and HIV patients with PCP (adjusted odds ratio, 1.4; 95% CI, 0.9 to 2.3). CONCLUSION: The epidemiology of PCP has shifted with an increase in the prevalence of non-HIV patients who have higher intubation rates and prolonged hospitalizations compared with matched HIV patients.
OBJECTIVE: To assess host factors in pneumocystis jirovecii pneumonia (PCP)-related hospitalizations and compare outcomes between HIV and non-HIVpatients. METHODS: Using the National Inpatient Sample database, we identified 3384 hospitalizations with PCP (International Classification of Diseases, Ninth Revision, Clinical Modification code: 136.3) as the primary discharge diagnosis from 2005 to 2014. We evaluated hospitalizations for the following host factors: HIV, malignancies, organ transplantation, rheumatologic diseases, and vasculitides. We compared the prevalence of individual host factors among PCP hospitalizations over time, and compared intervention rates and outcomes between HIV and non-HIVpatients with PCP. RESULTS: Among all hospitalizations for PCP, malignancy was the most prevalent host factor (46.0%, n=1559), followed by HIV (17.8%, n=604); 60.7% (n=946) of malignancies were hematologic. The prevalence of HIV among hospitalizations for PCP decreased from 25.1% in 2005 to 9.2% in 2014 (P<.001), whereas the prevalence of non-HIV immunocompromising conditions increased. Compared with HIVpatients, PCP patients without HIV had higher rates of bronchoscopy (52.3% vs 26.7%, P<.001) and endotracheal intubation (17.0% vs 7.9%, P<.001), prolonged hospitalizations (11.5 vs 8.7 days, P<.001), higher hospitalization costs (86.8 vs 48.2×103 USD, P<.001) and increased in-hospital mortality (16.0% vs 5.0%, P<.001). After adjusting for age, sex, and smoking status, there was no difference in mortality between non-HIV and HIVpatients with PCP (adjusted odds ratio, 1.4; 95% CI, 0.9 to 2.3). CONCLUSION: The epidemiology of PCP has shifted with an increase in the prevalence of non-HIVpatients who have higher intubation rates and prolonged hospitalizations compared with matched HIVpatients.
Authors: Benedikt Kolbrink; Jubin Scheikholeslami-Sabzewari; Christoph Borzikowsky; Friedrich A von Samson-Himmelstjerna; Andrew J Ullmann; Ulrich Kunzendorf; Kevin Schulte Journal: Lancet Reg Health Eur Date: 2022-05-15
Authors: Emily G McDonald; Guillaume Butler-Laporte; Olivier Del Corpo; Jimmy M Hsu; Alexander Lawandi; Julien Senecal; Zahra N Sohani; Matthew P Cheng; Todd C Lee Journal: Open Forum Infect Dis Date: 2021-10-29 Impact factor: 3.835
Authors: Aldair Chaar-Hernandez; Jorge Montes; Maria C Rojas; Diego A Padilla-Mantilla; Abdelilah Lahmar; Juan F Toledo-Martinez; Francisco J Somoza-Cano Journal: Cureus Date: 2022-05-26