Admitted AIDS-associated Kaposi sarcoma patients
| Autor: | Wencilaus Margret Pious Selvaraj, Faheema Vally, Owen Ngalamika |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty HIV-associated Zambia Observational Study Admitted sepsis Sepsis Young Adult 03 medical and health sciences Patient Admission 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine Young adult Sarcoma Kaposi Retrospective Studies Univariate analysis AIDS-Related Opportunistic Infections Respiratory tract infections business.industry Kaposi sarcoma Retrospective cohort study General Medicine Odds ratio Middle Aged medicine.disease mortality Confidence interval predictors 030220 oncology & carcinogenesis Female business Viral load Research Article |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 0025-7974 |
| DOI: | 10.1097/md.0000000000022415 |
| Popis: | Kaposi sarcoma (KS) is an AIDS-defining angioproliferative malignancy associated with high morbidity and mortality. Most KS patients in regions with high incidence such as sub-Saharan Africa present late with advanced stage disease. Admitted KS patients have high mortality rates. Factors associated with mortality of admitted KS patients are poorly defined.We conducted a retrospective file review to ascertain reasons for admission and identify factors associated with mortality of admitted HIV-associated (epidemic) KS patients in Zambia. Baseline study variables were collected, and patients were retrospectively followed from admission to time of discharge or death.Mortality rate for admitted epidemic KS patients was high at 20%. The most common reasons for admission included advanced KS disease, severe anemia, respiratory tract infections, and sepsis. The majority (48%) of admitted patients had advanced clinical stage with visceral involvement on admission. Clinical predictors of mortality on univariate analysis included visceral KS [odds ratio (OR)â=â13.74; 95% confidence interval (95% CI)â=â1.68-113; Pâ=â0.02), fever (ORâ=â26; 95% CIâ=â4.85-139; Pâ=â.001), and sepsis (ORâ=â35.56; 95% CIâ=â6.05-209; Pâ=â.001). Baseline hemoglobin levels (5.6 vs 8.2âg/dL; Pâ=â.001) and baseline platelet counts (63âxâ10^9/L vs 205âxâ10^9/L; Pâ=â.01) were significantly lower in mortalities vs discharges. Baseline white cell counts were higher in mortalities vs discharges (13.78âxâ10^9/L vs 5.58âxâ10^9/L; Pâ=â.01), and HIV-1 viral loads at the time of admission were higher in mortalities vs discharges (47,607 vs 40âcopies/µL; Pâ=â.02). However, only sepsis (or signs and symptoms of sepsis) were independently associated with mortality after controlling for confounders.In conclusion, common reasons for admission of epidemic KS patients include advanced disease, severe anemia, respiratory tract infections, and signs and symptoms of sepsis. Signs and symptoms of sepsis are independent predictors of mortality in these patients. |
| Databáze: | OpenAIRE |
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