학술논문

Medical Intensive Care Unit Admission Among Patients With and Without HIV, Hepatitis C Virus, and Alcohol-Related Diagnoses in the United States
Document Type
article
Source
JAIDS Journal of Acquired Immune Deficiency Syndromes. 80(2)
Subject
Liver Disease
Hepatitis - C
Hepatitis
Chronic Liver Disease and Cirrhosis
HIV/AIDS
Infectious Diseases
Substance Misuse
Digestive Diseases
Clinical Research
Alcoholism
Alcohol Use and Health
Emerging Infectious Diseases
Aetiology
2.2 Factors relating to the physical environment
Infection
Good Health and Well Being
Adult
Alcohol Drinking
Alcohol-Related Disorders
Coinfection
Female
HIV Infections
Hepatitis C
Humans
Intensive Care Units
Male
Middle Aged
Patient Admission
Retrospective Studies
Risk Factors
United States
intensive care units
HIV
hepatitis C
alcoholism
electronic health records
veterans
Clinical Sciences
Public Health and Health Services
Virology
Language
Abstract
BackgroundHIV, hepatitis C virus (HCV), and alcohol-related diagnoses (ARD) independently contribute increased risk of all-cause hospitalization. We sought to determine annual medical intensive care unit (MICU) admission rates and relative risk of MICU admission between 1997 and 2014 among people with and without HIV, HCV, and ARD, using data from the largest HIV and HCV care provider in the United States.SettingVeterans Health Administration.MethodsAnnual MICU admission rates were calculated among 155,550 patients in the Veterans Aging Cohort Study by HIV, HCV, and ARD status. Adjusted rate ratios and 95% confidence intervals (CIs) were estimated with Poisson regression. Significance of trends in age-adjusted admission rates were tested with generalized linear regression. Models were stratified by calendar period to identify shifts in MICU admission risk over time.ResultsCompared to HIV-/HCV-/ARD- patients, relative risk of MICU admission decreased among HIV-mono-infected patients from 61% (95% CI: 1.56 to 1.65) in 1997-2009% to 21% (95% CI: 1.16 to 1.27) in 2010-2014, increased among HCV-mono-infected patients from 22% (95% CI: 1.16 to 1.29) in 1997-2009% to 54% (95% CI: 1.43 to 1.67) in 2010-2014, and remained consistent among patients with ARD only at 46% (95% CI: 1.42 to 1.50). MICU admission rates decreased by 48% among HCV-uninfected patients (P-trend