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Risk factors for death in acquired immunodeficiency syndrome-associated disseminated histoplasmosis
Authors:de Francesco Daher Elizabeth  de Sousa Barros Fernando Antonio  da Silva Júnior Geraldo Bezerra  Takeda Christianne Fernandes Valente  Mota Rosa Maria Salani  Ferreira Marúsia Thomaz  Martins Julieta Cunha  Oliveira Soraya Alves Jacinto  Gutiérrez-Adrianzén Oswaldo Augusto
Affiliation:Department of Internal Medicine, Faculdade de Medicina, Hospital Universitário Walter Cantídio. efdaher@for.terra.com.br
Abstract:We performed a retrospective study of 164 human immunodeficiency virus (HIV)-infected patients with disseminated histoplasmosis to identify the risk factors for death. Death occurred in 32% of the cases. Univariate analysis identified the following risk factors: diarrhea (odds ratio [OR] = 3.9, P = 0.001), neurologic manifestations (OR = 5.8, ; P = 0.001), hemoglobin level < 8.0g/dL (OR = 2.7, P = 0.004), urea level 2 times the normal upper limit (OR = 5.0, P < 0.001), creatinine level > 1.5 mg/dL (OR = 2.9, P = 0.005), aspartate aminotransferase (AST) level > 2.5 times the normal upper limit (OR = 3.1, P = 0.01), respiratory insufficiency (OR = 9.7, P < 0.001), sepsis (OR = 20.2, P < 0.001), and acute renal failure (OR = 2.5, P = 0.011). A hemoglobin level < 8.0 g/dL (OR = 3.8, P = 0.008), an AST level >or= 2.5 times the normal limit (OR = 1.0, P = 0.007), acute renal failure (OR = 2.96, P = 0.015), and respiratory insufficiency (OR = 12.2, P = 0.01) were independent risk factors for death.
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