Mortality and Length of Stay Among HIV Patients Hospitalized for Heart Failure: A Multicenter Retrospective Study

Jonathan Brown; Ashwin Srinivasan; Hytham Rashid; Brendon Cornett; Syed Raza; Zuhair Ali

Mortality and Length of Stay Among HIV Patients Hospitalized for Heart Failure: A Multicenter Retrospective Study

Jonathan Brown
, Ashwin Srinivasan
, Hytham Rashid
, Brendon Cornett
, Syed Raza
, Zuhair Ali

HCA Houston Healthcare Kingwood

HCA Healthcare

Research output: Contribution to journal › Article › peer-review

Abstract

<p> <h3 id="x-x-st0010"> Study objective </h3> <p id="x-x-sp0050"> The purpose of our study was to determine if CD4+ T-lymphocyte count (CD4 count) was inversely associated with inpatient mortality and length of stay (LOS) among patients with HIV hospitalized for <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/acute-decompensated-heart-failure" title="Learn more about acute heart failure from ScienceDirect's AI-generated Topic Pages"> acute heart failure </a> . <h3 id="x-x-st0015"> Design </h3> <p id="x-x-sp0055"> <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/retrospective-cohort-study" title="Learn more about Retrospective cohort study from ScienceDirect's AI-generated Topic Pages"> Retrospective cohort study </a> . <h3 id="x-x-st0020"> Setting </h3> <p id="x-x-sp0060"> HCA hospitals throughout the United States. <h3 id="x-x-st0025"> Participants </h3> <p id="x-x-sp0065"> 1704 patients with human immunodeficiency virus (HIV) hospitalized for acute heart failure with a documented, time-updated CD4 count. <h3 id="x-x-st0030"> Interventions </h3> <p id="x-x-sp0070"> Patients were categorized by CD4 count ranges consisting of >500, 200–499, <200 cells/μL. <h3 id="x-x-st0035"> Main outcome measures </h3> <p id="x-x-sp0075"> A multivariable negative binomial regression was performed with CD4 count as a predictor of length of stay. Multivariable <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/logistic-regression-analysis" title="Learn more about logistic regression from ScienceDirect's AI-generated Topic Pages"> logistic regression </a> was performed with CD4 count as a predictor of mortality. <h3 id="x-x-st0040"> Results </h3> <p id="x-x-sp0080"> A CD4 count <200 cells/μL was associated with an increased length of stay compared to a CD4 > 500 cells/μL (IRR 1.24, 95 % CI: 1.11 to 1.39, P ≤ 0.01). A CD4 of 200–499 cells/μL was associated with a shorter LOS compared to a CD4 < 200 cells/μL (IRR 0.82, 95 % CI: 0.75 to 0.89, P ≤ 0.01). A CD4 < 200 cells/μL was associated with an increased mortality compared to a CD4 > 500 cells/μL (OR 3.62, 95 % CI: 1.63 to 8.05, P ≤ 0.01). CD4 count was not independently associated with in-patient mortality after adjusting for viral load. <h3 id="x-x-st0045"> Conclusion </h3> <p id="x-x-sp0085"> A time-updated CD4 count <200 cells/μL on hospital admission was independently associated with increased length of stay. CD4 cell count and viral load are important markers when considering the morbidity and mortality among patients with HIV hospitalized for acute heart failure. </p> </p> </p> </p> </p> </p> </p> </p></p>

Original language	American English
Article number	100193
Journal	American Heart Journal Plus: Cardiology Research and Practice
Volume	20
State	Published - Aug 1 2022

Keywords

Acute heart failure
Human immunodeficiency virus
In-hospital mortality
Length of stay

Disciplines

Cardiovascular Diseases
Immune System Diseases
Internal Medicine

Access to Document

https://doi.org/10.1016/j.ahjo.2022.100193

Cite this

@article{7647a209498a4267aff67f95f977ee15,

title = "Mortality and Length of Stay Among HIV Patients Hospitalized for Heart Failure: A Multicenter Retrospective Study",

abstract = " Study objective The purpose of our study was to determine if CD4+ T-lymphocyte count (CD4 count) was inversely associated with inpatient mortality and length of stay (LOS) among patients with HIV hospitalized for acute heart failure . Design Retrospective cohort study . Setting HCA hospitals throughout the United States. Participants 1704 patients with human immunodeficiency virus (HIV) hospitalized for acute heart failure with a documented, time-updated CD4 count. Interventions Patients were categorized by CD4 count ranges consisting of >500, 200\–499, <200 cells/\μL. Main outcome measures A multivariable negative binomial regression was performed with CD4 count as a predictor of length of stay. Multivariable logistic regression was performed with CD4 count as a predictor of mortality. Results A CD4 count <200 cells/\μL was associated with an increased length of stay compared to a CD4 > 500 cells/\μL (IRR 1.24, 95 \% CI: 1.11 to 1.39, P \≤ 0.01). A CD4 of 200\–499 cells/\μL was associated with a shorter LOS compared to a CD4 < 200 cells/\μL (IRR 0.82, 95 \% CI: 0.75 to 0.89, P \≤ 0.01). A CD4 < 200 cells/\μL was associated with an increased mortality compared to a CD4 > 500 cells/\μL (OR 3.62, 95 \% CI: 1.63 to 8.05, P \≤ 0.01). CD4 count was not independently associated with in-patient mortality after adjusting for viral load. Conclusion A time-updated CD4 count <200 cells/\μL on hospital admission was independently associated with increased length of stay. CD4 cell count and viral load are important markers when considering the morbidity and mortality among patients with HIV hospitalized for acute heart failure. ",

keywords = "Acute heart failure, Human immunodeficiency virus, In-hospital mortality, Length of stay",

author = "Jonathan Brown and Ashwin Srinivasan and Hytham Rashid and Brendon Cornett and Syed Raza and Zuhair Ali",

note = "Brown J, Srinivasan A, Rashid H, Cornett B, Raza S, Ali Z. Mortality and length of stay among HIV patients hospitalized for heart failure: A multicenter retrospective study. Am Heart J Plus. 2022;20():100193. doi:10.1016/j.ahjo.2022.100193",

year = "2022",

month = aug,

day = "1",

language = "American English",

volume = "20",

journal = "American Heart Journal Plus: Cardiology Research and Practice",

issn = "2666-6022",

}

TY - JOUR

T1 - Mortality and Length of Stay Among HIV Patients Hospitalized for Heart Failure: A Multicenter Retrospective Study

AU - Brown, Jonathan

AU - Srinivasan, Ashwin

AU - Rashid, Hytham

AU - Cornett, Brendon

AU - Raza, Syed

AU - Ali, Zuhair

N1 - Brown J, Srinivasan A, Rashid H, Cornett B, Raza S, Ali Z. Mortality and length of stay among HIV patients hospitalized for heart failure: A multicenter retrospective study. Am Heart J Plus. 2022;20():100193. doi:10.1016/j.ahjo.2022.100193

PY - 2022/8/1

Y1 - 2022/8/1

N2 - Study objective The purpose of our study was to determine if CD4+ T-lymphocyte count (CD4 count) was inversely associated with inpatient mortality and length of stay (LOS) among patients with HIV hospitalized for acute heart failure . Design Retrospective cohort study . Setting HCA hospitals throughout the United States. Participants 1704 patients with human immunodeficiency virus (HIV) hospitalized for acute heart failure with a documented, time-updated CD4 count. Interventions Patients were categorized by CD4 count ranges consisting of >500, 200–499, <200 cells/μL. Main outcome measures A multivariable negative binomial regression was performed with CD4 count as a predictor of length of stay. Multivariable logistic regression was performed with CD4 count as a predictor of mortality. Results A CD4 count <200 cells/μL was associated with an increased length of stay compared to a CD4 > 500 cells/μL (IRR 1.24, 95 % CI: 1.11 to 1.39, P ≤ 0.01). A CD4 of 200–499 cells/μL was associated with a shorter LOS compared to a CD4 < 200 cells/μL (IRR 0.82, 95 % CI: 0.75 to 0.89, P ≤ 0.01). A CD4 < 200 cells/μL was associated with an increased mortality compared to a CD4 > 500 cells/μL (OR 3.62, 95 % CI: 1.63 to 8.05, P ≤ 0.01). CD4 count was not independently associated with in-patient mortality after adjusting for viral load. Conclusion A time-updated CD4 count <200 cells/μL on hospital admission was independently associated with increased length of stay. CD4 cell count and viral load are important markers when considering the morbidity and mortality among patients with HIV hospitalized for acute heart failure.

AB - Study objective The purpose of our study was to determine if CD4+ T-lymphocyte count (CD4 count) was inversely associated with inpatient mortality and length of stay (LOS) among patients with HIV hospitalized for acute heart failure . Design Retrospective cohort study . Setting HCA hospitals throughout the United States. Participants 1704 patients with human immunodeficiency virus (HIV) hospitalized for acute heart failure with a documented, time-updated CD4 count. Interventions Patients were categorized by CD4 count ranges consisting of >500, 200–499, <200 cells/μL. Main outcome measures A multivariable negative binomial regression was performed with CD4 count as a predictor of length of stay. Multivariable logistic regression was performed with CD4 count as a predictor of mortality. Results A CD4 count <200 cells/μL was associated with an increased length of stay compared to a CD4 > 500 cells/μL (IRR 1.24, 95 % CI: 1.11 to 1.39, P ≤ 0.01). A CD4 of 200–499 cells/μL was associated with a shorter LOS compared to a CD4 < 200 cells/μL (IRR 0.82, 95 % CI: 0.75 to 0.89, P ≤ 0.01). A CD4 < 200 cells/μL was associated with an increased mortality compared to a CD4 > 500 cells/μL (OR 3.62, 95 % CI: 1.63 to 8.05, P ≤ 0.01). CD4 count was not independently associated with in-patient mortality after adjusting for viral load. Conclusion A time-updated CD4 count <200 cells/μL on hospital admission was independently associated with increased length of stay. CD4 cell count and viral load are important markers when considering the morbidity and mortality among patients with HIV hospitalized for acute heart failure.

KW - Acute heart failure

KW - Human immunodeficiency virus

KW - In-hospital mortality

KW - Length of stay

UR - https://scholarlycommons.hcahealthcare.com/internal-medicine/433

UR - https://doi.org/10.1016/j.ahjo.2022.100193

M3 - Article

SN - 2666-6022

VL - 20

JO - American Heart Journal Plus: Cardiology Research and Practice

JF - American Heart Journal Plus: Cardiology Research and Practice

M1 - 100193

ER -

Mortality and Length of Stay Among HIV Patients Hospitalized for Heart Failure: A Multicenter Retrospective Study

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