HIV-related emergencies

Autor: Donald Armstrong, Jonathan W. M. Gold, Raymond R. Chang, George Y. Wong
Rok vydání: 1993
Předmět:
Zdroj: Journal of General Internal Medicine. 8:465-469
ISSN: 1525-1497
0884-8734
DOI: 10.1007/bf02600105
Popis: Objective: To study the clinical epidemiology and outcome of HIV-related emergencies, and to identify clinical predictors of HIV-related emergency hospitalizatlons. Design: Case series. Setting: Emergency facility of a tertiary care teaching hospital. Patients: 350 HIV/AIDS patients followed at the authors’ center. Measurements and main results: 69 of 356 patients made 92 emergency visits with a frequency of 8% per month and 20% per quarter in a three-month study period. Forty-three visits (47%) resulted in hospitalization and contributed to 70% of total AIDS hospitalizations in the period. The five most common acute diagnoses were pneumonia (n=22; 24%), fever (n=15; 16%), upper respiratory infection (n=9; 10%), cellulitis (n=6; 7%), and gastroenteritis (n=6; 7%). Three diagnoses accounted for 70% of acute HIV hospitalizations: pneumonia (n=19), fever (n=4), and sepsis (n=4). Analysis of patient disposition as it relates to the patient’s clinical presentation and HIV history using multivariate analysis yielded 1) the presence of dyspnea or cough (p=0.015) and 2) fever with an abnormal chest x-ray (p=0.008) as independently predictive of hospitalization. Conclusion: The findings indicate that HIV/AIDS patients have a frequent need for emergency care and most HIV/AIDS hospitalizations are emergency-related. The acute problems of these patients are related to a limited number of diagnostic categories, and the presence of respiratory or constitutional symptoms with an abnormal chest radiograph are the only reliable factors predictive of hospitalization.
Databáze: OpenAIRE
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