14th Annual Conference of the British HIV Association 23-25 April 2008, Belfast

CHARACTERISTICS AND OUTCOMES OF HIV-INFECTED PATIENTS ADMITTED TO AN INNER LONDON INTENSIVE CARE UNIT

HIV Med 2008 Apr 23-25 (Suppl 1);14:8 (abstract no. O29)

E Hamlyn, S Bhatt, P Gruber, L Campbell, V Metaxa, C Pahl and M Poulton
King's College Hospital, London, UK

BACKGROUND: Studies indicate improved outcomes for HIV-infected patients admitted to the Intensive Care Unit (ICU) which may be independent of the use of antiretrovirals (ARV). We describe the characteristics and outcomes of HIV-infected patients admitted to an inner city ICU.

METHODS: Data on demographic, laboratory and ICU parameters, and hospital course were collected by retrospective case note review of patients admitted to ICU between 04/2004 and 4/2007.

RESULTS: Two thousand and thirty seven patients were admitted to ICU, of these 48 (2.4%) were HIV-infected and admitted on 58 occasions. Twenty two (46%) were female, 26 (54%) Black African, seven (14%) gay men, mean age 40 years (SD 10.4). There were significantly more intravenous drug users (IVDU) than in the general HIV clinic cohort (17% versus 5% p=0.001). Twenty (42%) were newly diagnosed with HIV. 15 patients (31%) were receiving ARV at the time of admission. Median CD4 cell count was 142 cell/mm³ (IQR 12-254). Thirty patients (63%) had an HIV related cause of hospital admission; 21 of which were AIDS defining. Median APACHE II score was 24 (IQR 20-29). In-hospital mortality was 48% in HIV-infected patients compared to 36% in non HIV-infected patients (p=0.07). On univariate analysis, factors associated with mortality included: higher APACHE II score (OR 1.08/unit increase, p=0.04), platelet count <100 (OR 4.4, p=0.003), high creatinine (OR 4.2 95%, p=0.02), organ failure >1 (OR 8.75, p=0.012). Absence of ARV was of borderline significance (OR 3.7, p=0.05).

CONCLUSIONS: Nearly half of HIV-infected patients admitted to ICU were newly diagnosed highlighting the problems associated with late presentation. A higher proportion of IVDU were admitted compared to the general HIV clinic population. Mortality was not significantly higher than in non HIV-infected patients.

2008-04-23
O29

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