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Predictors of death within six months in patients with advanced AIDS

Published online by Cambridge University Press:  13 April 2006

JOHN R. BRECHTL ,
PATRICIA A. PATRICK ,
PAUL VISINTAINER  and
DONALD A. BRAND
JOHN R. BRECHTL
Affiliation:
Terence Cardinal Cooke Health Care Center, New York, New York, USA Department of Medicine, New York Medical College, Valhalla, New York, USA
PATRICIA A. PATRICK
Affiliation:
Department of Medicine, New York Medical College, Valhalla, New York, USA Primary Care Research Unit, New York Medical College, Valhalla, New York, USA
PAUL VISINTAINER
Affiliation:
School of Public Health, New York Medical College, Valhalla, New York, USA
DONALD A. BRAND
Affiliation:
Department of Medicine, New York Medical College, Valhalla, New York, USA Primary Care Research Unit, New York Medical College, Valhalla, New York, USA
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Abstract

Objectives: This study sought to identify potential predictive variables of death within 6 months in patients with advanced AIDS.

Methods: Investigators enrolled a consecutive series of patients with advanced AIDS admitted to a skilled nursing facility in New York City over a 1-year period. Demographic, clinical, laboratory, and outcome data were abstracted from medical records using a standardized data collection instrument.

Results: Of the 152 patients enrolled during the study period, 61 patients (40%) died within 6 months from date of admission. Serum albumin, percent deviation from ideal body weight, and number of comorbidities at the time of admission proved to be the best combination of predictors of death within 6 months.

Significance of results: The decrease in AIDS mortality over the past decade, along with an increase in prevalence due to longer survival, has been attributed primarily to the successful use of highly active antiretroviral therapy (HAART). HAART regimens, however, can also produce both short-term adverse effects and long-term complications. The prognostic model developed by this study may be useful in guiding treatment decisions in patients with advanced AIDS for whom a more palliative care plan may be sought.

Keywords

Acquired Immunodeficiency Syndrome/mortalityAdultAntiretroviral therapyHighly activeDecision makingPalliative care
Type
ORIGINAL ARTICLES
Information
Palliative & Supportive Care , Volume 3 , Issue 4 , December 2005 , pp. 265 - 272
Copyright
© 2005 Cambridge University Press

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