PLoS ONE (Jan 2015)

A Clinical Predictor Score for 30-Day Mortality among HIV-Infected Adults Hospitalized with Pneumonia in Uganda.

  • Catherine A Koss,
  • Leah G Jarlsberg,
  • Saskia den Boon,
  • Adithya Cattamanchi,
  • J Lucian Davis,
  • William Worodria,
  • Irene Ayakaka,
  • Ingvar Sanyu,
  • Laurence Huang,
  • International HIV-associated Opportunistic Pneumonias (IHOP) Study

DOI
https://doi.org/10.1371/journal.pone.0126591
Journal volume & issue
Vol. 10, no. 5
p. e0126591

Abstract

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BackgroundPneumonia is a major cause of mortality among HIV-infected patients. Pneumonia severity scores are promising tools to assist clinicians in predicting patients' 30-day mortality, but existing scores were developed in populations infected with neither HIV nor tuberculosis (TB) and include laboratory data that may not be available in resource-limited settings. The objective of this study was to develop a score to predict mortality in HIV-infected adults with pneumonia in TB-endemic, resource-limited settings.MethodsWe conducted a secondary analysis of data from a prospective study enrolling HIV-infected adults with cough ≥2 weeks and ResultsOverall, 835 patients were studied (mean age 34 years, 53.4% female, 30-day mortality 18.2%). A four-point clinical predictor score was identified and included heart rate >120 beats/minute, respiratory rate >30 breaths/minute, oxygen saturation ConclusionsA simple, four-point scoring system can stratify patients by levels of risk for mortality. Rapid identification of higher risk patients combined with provision of timely and appropriate treatment may improve clinical outcomes. This predictor score should be validated in other resource-limited settings.