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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
5
|
| pubmed:dateCreated |
1996-2-23
|
| pubmed:abstractText |
Pneumocystis carinii pneumonia (PCP) in HIV-infected patients remains a life-threatening complication in the course of HIV infection. Despite effective treatment, mortality may still be as high as 10%. The identification of risk factors associated with a lethal outcome might be helpful as a guide to therapy for patients at risk and in the evaluation of new drugs with anti-pneumocystic activity. In a retrospective study 58 first episodes of HIV-associated PCP without prophylaxis were analyzed. Variables associated univariately with higher mortality were identified. A prognostic rule was established in a multivariate approach using canonical discriminant analysis. Cut-off values for parameters included were determined in order to allow a clinically applicable estimate of the individual risk. Variables associated with early mortality were hemoglobin, hematocrit, platelet count, albumin, total protein, gamma-globulins, and AaDO2. LDH values, percentage of neutrophils in the BAL, as well as the cellular immunologic state as indicated by CD4-cell count were not significantly associated with the outcome. The discriminant function yielded the best classification results with the inclusion of hemoglobin, albumin, and gamma-globulins (overall accuracy 86%). Two or more of the following parameters were associated with a 14-fold increased risk of in-hospital mortality: hemoglobin less than 10 g/dl, albumin less than 3 g/dl, and gamma-globulins less than 1.2 g/dl. This prognostic rule was 80% sensitive and 94% specific with a negative predictive value of 94%, yielding an overall accuracy of 91%. Patients with HIV-associated PCP with a positive prognostic rule have a 14-fold increased risk for in-hospital lethal outcome. This discriminant rule may be helpful in identifying patients at risk.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:status |
MEDLINE
|
| pubmed:issn |
0300-8126
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
23
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
272-7
|
| pubmed:dateRevised |
2004-11-17
|
| pubmed:meshHeading |
pubmed-meshheading:8557384-AIDS-Related Opportunistic Infections,
pubmed-meshheading:8557384-Adult,
pubmed-meshheading:8557384-Bacterial Infections,
pubmed-meshheading:8557384-Bronchoalveolar Lavage,
pubmed-meshheading:8557384-Candidiasis,
pubmed-meshheading:8557384-Female,
pubmed-meshheading:8557384-Hospitals,
pubmed-meshheading:8557384-Humans,
pubmed-meshheading:8557384-Leukocyte Count,
pubmed-meshheading:8557384-Male,
pubmed-meshheading:8557384-Multivariate Analysis,
pubmed-meshheading:8557384-Outcome Assessment (Health Care),
pubmed-meshheading:8557384-Pneumonia, Pneumocystis,
pubmed-meshheading:8557384-Retrospective Studies,
pubmed-meshheading:8557384-Risk Factors
|
| pubmed:articleTitle |
Predicting in-hospital outcome in HIV-associated Pneumocystis carinii pneumonia.
|
| pubmed:affiliation |
Berufsgenossenschaftliche Kliniken Bergmannsheil, Abt. f. Pneumologie u. Allergologie, Bochum, Germany.
|
| pubmed:publicationType |
Journal Article
|