The Association Between HIV Infection and the Use of Palliative Care in Patients Hospitalized With Heart Failure.
Age Factors
Aged
CD4 Lymphocyte Count
Case-Control Studies
Comorbidity
Female
HIV Infections
/ epidemiology
Heart Failure
/ epidemiology
Hospitalization
/ statistics & numerical data
Humans
Length of Stay
/ statistics & numerical data
Logistic Models
Male
Middle Aged
Palliative Care
/ statistics & numerical data
Patient Discharge
Respiration, Artificial
/ statistics & numerical data
Risk Factors
Sex Factors
United States
/ epidemiology
United States Department of Veterans Affairs
HIV
end of life
heart failure
hospice
hospitalization
palliative care
Journal
The American journal of hospice & palliative care
ISSN: 1938-2715
Titre abrégé: Am J Hosp Palliat Care
Pays: United States
ID NLM: 9008229
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
pubmed:
12
10
2018
medline:
24
10
2020
entrez:
12
10
2018
Statut:
ppublish
Résumé
The number of adults with heart failure (HF) and HIV infection is increasing. These patients may benefit from palliative care (PC). Determine the association between HIV infection, other HIV characteristics, and PC among hospitalized patients with HF in the Veterans Health Administration (VHA). Nested case-control study of patients with HF hospitalized from 2003 to 2015 and enrolled in the Veterans Aging Cohort Study. Two hundred and ten hospitalized patients with HF who received PC matched to 1042 patients with HF who did not receive PC, by age, discharge date, and left ventricular ejection fraction. Palliative care use was the primary outcome. Independent variables included HIV infection identified by The sample was 99% male, mean age was 64 years (standard deviation ±10), 54% of cases and 59% of controls were black, and 30% of cases and 31% of controls were HIV-infected. In adjusted models, HIV as the primary diagnosis for hospitalization (odds ratio [OR]: 3.69, 95% confidence interval [CI]: 1.30-10.52), unsuppressed HIV-1 RNA (OR: 2.62, 95% CI: 1.31-5.24), and CD4 counts <200 cells/mm HIV characteristics indicative of severe disease are associated with PC for hospitalized VHA patients with HF. Increasing access to PC for patients with HF and HIV is warranted.
Sections du résumé
BACKGROUND
BACKGROUND
The number of adults with heart failure (HF) and HIV infection is increasing. These patients may benefit from palliative care (PC).
OBJECTIVES
OBJECTIVE
Determine the association between HIV infection, other HIV characteristics, and PC among hospitalized patients with HF in the Veterans Health Administration (VHA).
DESIGN
METHODS
Nested case-control study of patients with HF hospitalized from 2003 to 2015 and enrolled in the Veterans Aging Cohort Study.
SETTING/PATIENTS
METHODS
Two hundred and ten hospitalized patients with HF who received PC matched to 1042 patients with HF who did not receive PC, by age, discharge date, and left ventricular ejection fraction.
MEASUREMENTS
METHODS
Palliative care use was the primary outcome. Independent variables included HIV infection identified by
RESULTS
RESULTS
The sample was 99% male, mean age was 64 years (standard deviation ±10), 54% of cases and 59% of controls were black, and 30% of cases and 31% of controls were HIV-infected. In adjusted models, HIV as the primary diagnosis for hospitalization (odds ratio [OR]: 3.69, 95% confidence interval [CI]: 1.30-10.52), unsuppressed HIV-1 RNA (OR: 2.62, 95% CI: 1.31-5.24), and CD4 counts <200 cells/mm
CONCLUSIONS
CONCLUSIONS
HIV characteristics indicative of severe disease are associated with PC for hospitalized VHA patients with HF. Increasing access to PC for patients with HF and HIV is warranted.
Identifiants
pubmed: 30304939
doi: 10.1177/1049909118804465
pmc: PMC7457998
mid: NIHMS1613822
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
228-234Subventions
Organisme : NIAAA NIH HHS
ID : U01 AA020790
Pays : United States
Organisme : NIAAA NIH HHS
ID : U10 AA013566
Pays : United States
Organisme : NIAAA NIH HHS
ID : U24 AA020794
Pays : United States
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