Journal Article

Clinical Stability in Human Immunodeficiency Virus—Infected Patients with Community-Acquired Pneumonia

P. Viale, L. Scudeller, N. Petrosillo, E. Girardi, B. Cadeo, L. Signorini, L. Pagani and G. Carosi

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 2, pages 271-279
Published in print January 2004 | ISSN: 1058-4838
Published online January 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/380788
Clinical Stability in Human Immunodeficiency Virus—Infected Patients with Community-Acquired Pneumonia

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Clinical stability (CS), defined as normalization of vital signs, is often used to manage inpatients with community-acquired pneumonia (CAP). The main objective of our study was to identify a reliable definition of CS for human immunodeficiency virus (HIV)–positive patients with CAP. During an 18-month period, 437 HIV-positive Italian inpatients with CAP were enrolled in the study. We used 3 definitions of CS (from a less conservative [definition 1] to a more conservative [definition 3] definition) based on combinations of different thresholds for vital signs. Assessments were performed at admission and daily during the hospital stay. For the 3 definitions, 14.9%, 8.0%, and 4.8% of patients were stable at baseline, with deterioration after reaching CS in 7.16%, 4.76%, and 2.05%, respectively. The 8 patients whose conditions deteriorated after reaching CS definition 3 (systolic blood pressure, >90 mm Hg; pulse, <90 beats/min; respiratory rate, <20 breaths/min; oxygen saturation, >90%; temperature, <37°C; ability to eat; and normal mental status) survived and were discharged from the hospital. The more conservative definition of CS appears to be reliable for the management of HIV-infected patients with CAP.

Journal Article.  4532 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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