Clinical outcome and predictors of survival in patients with pneumocystis jirovecii pneumonia - results of a tertiary referral centre
| Autor: | Thomas Gosseling, T Meister, Dirk Domagk, Achim Heinecke, Felicitas Roembke, Hauke Heinzow, Wolfram Domschke |
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| Rok vydání: | 2013 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Multivariate analysis business.industry Proportional hazards model Tertiary referral centre Pneumocystis jirovecii Pneumonia Human immunodeficiency virus (HIV) Respiratory infection medicine.disease_cause Pneumocystis pneumonia medicine.disease Intensive care unit law.invention law Internal medicine medicine Immunology and Allergy Intensive care medicine business Genetics (clinical) |
| Zdroj: | The Clinical Respiratory Journal. 8:86-92 |
| ISSN: | 1752-6981 |
| Popis: | Background and Aims Pneumocystis jirovecii pneumonia also known as pneumocystis pneumonia (PCP) is an opportunistic respiratory infection in human immunodeficiency virus (HIV) patients that may also develop in non-HIV immunocompromised persons. The aim of our study was to evaluate mortality predictors of PCP patients in a tertiary referral centre. Methods Fifty-one patients with symptomatic PCP were enrolled in the study. The patients had either HIV infection (n = 21) or other immunosuppressive conditions (n = 30). Baseline characteristics (e.g. age, sex and underlying disease) were retrieved. Kaplan–Meier analysis was employed to calculate survival. Comparisons were made by log-rank test. A multivariate analysis of factors influencing survival was carried out using the Cox regression model. Chi-squared test and Wilcoxon–Mann–Whitney test was applied as appropriate. Results The median survival time for the HIV group was >120 months compared with 3 months for the non-HIV group (P = 0.009). Three-month survival probability was also significantly greater in the HIV group compared with the non-HIV group (90% vs 41%, P = 0.002). In univariate log-rank test, intensive care unit (ICU) necessity, HIV negativity, age >50 years, haemoglobin 5 mg/dL and multiple comorbidities were significant negative predictors of survival. In the Cox regression model, ICU and HIV statuses turned out to be independent prognostic factors of survival. Conclusion PCP is a serious problem in non-HIV immunocompromised patients in whom survival outcomes are worse than those in HIV patients. |
| Databáze: | OpenAIRE |
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