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

Authors

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

Division

Gulf Coast

Hospital

HCA Houston Healthcare Kingwood

Document Type

Manuscript

Publication Date

8-2022

Keywords

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

Disciplines

Cardiovascular Diseases | Immune System Diseases | Internal Medicine

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.

Publisher or Conference

American Heart Journal Plus: Cardiology Research and Practice

Recommended Citation

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