PROGNOSTIC FACTORS OF EARLY FATAL OUTCOME AND LONG-TERM SURVIVAL IN PATIENTS WITH PNEUMOCYSTIS-CARINII PNEUMONIA AND ACQUIRED-IMMUNODEFICIENCY-SYNDROME

被引:20
作者
ANTINORI, A
MAIURO, G
PALLAVICINI, F
VALENTE, F
VENTURA, G
MARASCA, G
MURRI, R
PIZZIGALLO, E
CAMILLI, G
TAMBURRINI, E
机构
[1] Clinica delle Malattie Infettive, Università Cattolica S. Cuore, Roma, 00168, L.go A. Gemelli
关键词
AIDS; HIV INFECTION; PNEUMOCYSTIS-CARINII; PROGNOSTIC FACTORS; SURVIVAL;
D O I
10.1007/BF00158789
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Fifty-five episodes of Pneumocystis carinii pneumonia (PCP) in AIDS patients were evaluated to assess clinical and laboratory risk factors predicting the probability of surviving the acute episode of PCP and the long-term survival after PCP. Age > 45 yrs, PaO2 < 50 mmHg, AaPO2 > 50 mmHg, and LDH > 800 IU/L correlated strongly with early mortality; patients who needed mechanical ventilation had a significantly lower PaO2 and serum albumin, and higher AaPO2 and LDH compared to the patients who did not. Neither age nor PaO2, AaPO2, LDH, albumin, days from onset, time for recovery, CD4+ cell count correlated with long-term survival of AIDS patients with PCP. Informations obtained at initial presentation of PCP may predict early outcome and influence therapeutic approach, improving chances for survival.
引用
收藏
页码:183 / 189
页数:7
相关论文
共 30 条
  • [1] Allegra C.J., Chabner B.A., Tuazon C.U., OgataArakaki D., Baird B., Drake J.C., Simmons T., Lack E.E., Shelhamer J.H., Balis F., Walker R., Kovacs J.A., Lane H.C., Masur H., Trimetrexate for the treatment of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome, N. Engl. J. Med., 317, pp. 878-985, (1987)
  • [2] Armitage P., Berry G., Statistical methods in medical research, (1987)
  • [3] Bozzette S.A., Sattler F.R., Chiu J., Wu A.W., Gluckstein D., Kemper C., Bartok A., Niosi J., Abraon I., Coffman J., Hughlett C., Loya R., Cassens B., Akil B., Meng T-C., Boylen C.T., Nielsen D., Richman D.D., Tilles J.G., Leedom J., McCutchan J.A., A controlled trial of early adjunctive treatment with corticosteroids for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome, N. Engl. J. Med., 323, pp. 1451-1457, (1990)
  • [4] Brenner M., Ognibene F.R., Lack E.E., Simmons J.T., Suffredini A.F., Lane H.C., Fauci A.S., Parrillo J.E., Shelhamer J.H., Masur H., Prognostic factors and life expectancy of patients with acquired immunodeficiency syndrome and Pneumocystis carinii pneumonia, Am. Rev. Respir. Dis., 136, pp. 1199-1206, (1987)
  • [5] Guidelines for prophylaxis against Pneumocystis carinii pneumonia for persons with human immunodeficiency virus infection, M.M.W.R., 38, pp. 1-9, (1989)
  • [6] El-Sadr W., Simberkoff M.S., Survival and prognostic factors in severe Pneumocystis carinii pneumonia requiring mechanical ventilation, Am. Rev. Respir. Dis., 137, pp. 1264-1267, (1988)
  • [7] Fischl M.A., Richman D.D., Grieco M.H., The efficacy of azidothymydine (AZT) in the treatment of patients with AIDS and AIDS-related complex, N. Engl. J. Med., 317, pp. 185-191, (1987)
  • [8] Friedman Y., Franklin C., Rackow E.C., Weil M.H., Improved survival in patients with AIDS, Pneumocystis carinii pneumonia, and severe respiratory failure, Chest, 96, pp. 862-866, (1991)
  • [9] Gagnon S., Boota A.M., Fischl M.A., Baier H., Kirksey O.W., La Voie L., Cortocosteroids as adjunctive therapy for severe Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. A double blind, placebo-controlled trial, N. Engl. J. Med., 323, pp. 1444-1450, (1990)
  • [10] Garay S.M., Gren J., Prognostic indicators in the initial presentation of Pneumocystis carinii pneumonia, Chest, 95, pp. 769-772, (1989)