Document Detail


Pneumocystis carinii pneumonia and respiratory failure in AIDS. Improved outcomes and increased use of intensive care units.
MedLine Citation:
PMID:  1990936     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine whether the outcome of intensive care for patients with AIDS, Pneumocystis carinii pneumonia (PCP), and respiratory failure has changed, we studied patients admitted to the intensive care units an San Francisco General Hospital from 1981 to 1988. We compared the course of patients with PCP and respiratory failure admitted to the intensive care unit from 1986 to 1988 with a similar cohort hospitalized from 1981 to 1985. The hospital survival rate for the 35 patients in the 1986 to 1988 cohort was 40%, compared with 14% for the 42 patients in the 1981 to 1985 cohort (p less than 0.01). Age, episode of PCP, time since AIDS diagnosis, anti-PCP therapy, and important clinical variables were similar in both cohorts. Corticosteroids were used commonly in the recent era. Patients who received steroids had an in-hospital survival rate of 46%, compared with 22% for those who did not receive steroids (p = NS). In a stepwise logistic regression model, ICU care in the recent era and higher serum albumin at the time of ICU admission were the only variables significantly associated with survival. The hospital survival of patients with PCP and respiratory failure has improved. The improvement could not be explained by patient selection or by better anti-PCP therapy. The apparent beneficial effect of corticosteroids deserves further study. The improvement in ICU outcome was reflected in increased ICU utilization by patients with AIDS, PCP, and respiratory failure.
Authors:
R M Wachter; M B Russi; D A Bloch; P C Hopewell; J M Luce
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American review of respiratory disease     Volume:  143     ISSN:  0003-0805     ISO Abbreviation:  Am. Rev. Respir. Dis.     Publication Date:  1991 Feb 
Date Detail:
Created Date:  1991-03-07     Completed Date:  1991-03-07     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370523     Medline TA:  Am Rev Respir Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  251-6     Citation Subset:  AIM; IM; X    
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MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / complications*,  mortality,  therapy
Critical Care
Humans
Pneumonia, Pneumocystis / complications*,  mortality,  therapy
Prognosis
Respiratory Insufficiency / etiology*,  mortality,  therapy
Grant Support
ID/Acronym/Agency:
06211-01//PHS HHS; HS-05791/HS/AHRQ HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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