Predictors of in-hospital mortality among HIV-positive patients presenting with an acute illness to the emergency department

dc.contributor.authorLaher, Abdullah E.
dc.contributor.authorParuk, Fathima
dc.contributor.authorVenter, Willem Daniel Francois
dc.contributor.authorAyeni, Oluwatosin A.
dc.contributor.authorRichards, Guy A.
dc.date.accessioned2022-11-10T09:21:49Z
dc.date.available2022-11-10T09:21:49Z
dc.date.issued2021-08
dc.description.abstractOBJECTIVES : Despite better access to antiretroviral therapy (ART) over recent years, HIV remains a major global cause of mortality. The present study aimed to identify predictors of in-hospital mortality among HIV-positive patients presenting to an emergency department (ED). METHODS : In this cross-sectional study, HIV-positive patients presenting to the Charlotte Maxeke Johannesburg Academic Hospital adult ED between 07 July 2017 and 18 October 2018 were prospectively enrolled. Data were compared between participants who survived to hospital discharge and those who died. The data were further subjected to univariate and multivariate logistic regression analyses to determine variables that were associated with in-hospital mortality. RESULTS : Of a total of 1224 participants, the in-hospital mortality was 13.6% (n = 166). On multivariate analysis, respiratory rate > 20 breaths/min [odds ratio (OR) = 1.90, P = 0.012], creatinine > 120 μmol/L (OR = 1.97, P = 0.006), oxygen saturation < 90% (OR = 2.09, P = 0.011), white cell count < 4.0 × 109/L (OR = 2.09, P = 0.008), ART non-adherence or not yet on ART (OR = 2.39, P = 0.012), Glasgow Coma Scale < 15 (OR = 2.53, P = 0.000), albumin < 35 g/L (OR = 2.61, P = 0.002), lactate > 2 mmol/L (OR = 4.83, P = 0.000) and cryptococcal meningitis (OR = 6.78, P = 0.000) were significantly associated with in-hospital mortality. CONCLUSIONS : Routine clinical and laboratory parameters are useful predictors of in-hospital mortality in HIV-positive patients presenting to the ED with an acute illness. These parameters may be of value in guiding clinical decision-making, directing the appropriate use of resources and influencing patient disposition, and may also be useful in developing an outcome prediction tool.en_US
dc.description.departmentCritical Careen_US
dc.description.librarianhj2022en_US
dc.description.urihttp://www.wileyonlinelibrary.com/journal/hiven_US
dc.identifier.citationLaher, A.E., Paruk, F., Venter, W.D.F. et al. 2021, 'Predictors of in-hospital mortality among HIV-positive patients presenting with an acute illness to the emergency department', HIV Medicine, vol. 22, no. 7, pp. 557-566, doi : 10.1111/hiv.13097.en_US
dc.identifier.issn1464-2662 (print)
dc.identifier.issn1468-1293 (online)
dc.identifier.other10.1111/hiv.13097
dc.identifier.urihttps://repository.up.ac.za/handle/2263/88239
dc.language.isoenen_US
dc.publisherWileyen_US
dc.rights© 2021 British HIV Association. This is the pre-peer reviewed version of the following article : 'Predictors of in-hospital mortality among HIV-positive patients presenting with an acute illness to the emergency department', HIV Medicine, vol. 22, no. 7, pp. 557-566, 2021, doi : 10.1111/hiv.13097. The definite version is available at : http://www.wileyonlinelibrary.com/journal/hiv.en_US
dc.subjectOpportunistic infectionsen_US
dc.subjectHuman immunodeficiency virus (HIV)en_US
dc.subjectHIV viral loaden_US
dc.subjectHIV survivalen_US
dc.subjectAcute illnessen_US
dc.subjectAntiretroviral therapy (ART)en_US
dc.subjectCD4 cell counten_US
dc.subjectEmergency departmenten_US
dc.subjectIn-hospital mortality prediction (IMP)en_US
dc.subject.otherHealth sciences articles SDG-03
dc.subject.otherSDG-03: Good health and well-being
dc.titlePredictors of in-hospital mortality among HIV-positive patients presenting with an acute illness to the emergency departmenten_US
dc.typePostprint Articleen_US

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