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Clinical risk factors for in-hospital mortality in older adults with HIV infection: findings from a South African hospital administrative dataset

INTRODUCTION: The proportion of older South African adults (aged ≥50 years old) with HIV infection requiring hospitalization is likely to increase in the near future. Clinical risk factors for in-hospital mortality (IHM) in these patients are not well described. We aimed to identify clinical risk fa...

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Detalles Bibliográficos
Autores principales: Govender, Kumeren, Suleman, Fatima, Moodley, Yoshan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The African Field Epidemiology Network 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5429410/
https://www.ncbi.nlm.nih.gov/pubmed/28533849
http://dx.doi.org/10.11604/pamj.2017.26.126.11000
Descripción
Sumario:INTRODUCTION: The proportion of older South African adults (aged ≥50 years old) with HIV infection requiring hospitalization is likely to increase in the near future. Clinical risk factors for in-hospital mortality (IHM) in these patients are not well described. We aimed to identify clinical risk factors associated with IHM and their overall contribution towards IHM in older South African adults with HIV infection. METHODS: Clinical data for 690 older adults with HIV infection was obtained from the hospital administrative database at the Hlabisa Hospital in KwaZulu-Natal, South Africa. Logistic regression was used to determine independent clinical risk factors for IHM. Population-attributable fractions (PAFs) were calculated for all independent clinical risk factors identified. RESULTS: Male gender (p=0.005), CD4 count <350 cells/mm(3) (p=0.035), unknown CD4 count (p=0.048), tuberculosis (p=0.033) and renal failure (p=0.013) were independently associated with IHM. Male gender contributed the most to IHM (PAF=0.22), followed by unknown CD4 count (PAF=0.14), tuberculosis (PAF=0.12), renal failure (PAF=0.06) and CD4 count <350 cells/mm(3) (PAF=0.01). CONCLUSION: Although further research is required to confirm our findings, there is potential for these clinical risk factors identified in our study to be used to stratify patient risk and reduce IHM in older adults with HIV infection.