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 AND RESULTS: 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.
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 AND RESULTS: 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-infectedpatients. 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-infectedpatients with septic shock. Although severity of illness was clearly much more pronounced in HIV-positivepatients, retroviral infection was independently associated with death. Improving survival in HIV-positivepatients with septic shock may require earlier diagnosis and treatment of the causative infection.
Authors: G Sasson; A D Bai; A Showler; L Burry; M Steinberg; D R Ricciuto; T Fernandes; A Chiu; S Raybardhan; M Science; E Fernando; A M Morris; C M Bell Journal: Eur J Clin Microbiol Infect Dis Date: 2017-03-01 Impact factor: 3.267
Authors: André M Japiassú; Rodrigo T Amâncio; Emerson C Mesquita; Denise M Medeiros; Helena B Bernal; Estevão P Nunes; Paula M Luz; Beatriz Grinsztejn; Fernando A Bozza Journal: Crit Care Date: 2010-08-10 Impact factor: 9.097
Authors: David Morquin; Vincent Le Moing; Thibaut Mura; Alain Makinson; Kada Klouche; Olivier Jonquet; Jacques Reynes; Philippe Corne Journal: Ann Intensive Care Date: 2012-07-04 Impact factor: 6.925