Relevance of intracranial hypertension control in the management of Cryptococcus neoformans meningitis related to AIDS.
Purpose: To evaluate the relationship between intracranial hyperpressure (HICP) and mortality in patients with cryptococcal meningitis related to AIDS (CMRA). Methods: This was an observational retrospective study. Patients were treated according to the Infectious Diseases Society of America recomme...
| Published in: | Infection Vol. 41; no. 6; pp. 1073 - 1078 |
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| Main Authors: | , , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Springer Nature
Dec2013
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104118446&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104118446 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03008126 NXO jtl: Infection issn: 03008126 maglogo: N pubinfo: dt: Dec2013 vid: 41 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104118446 92014260 10.1007/s15010-013-0538-4 104118446 ppf: 1073 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Relevance of intracranial hypertension control in the management of Cryptococcus neoformans meningitis related to AIDS. aug: au: de Vedia, L. Arechavala, A. Calderón, M. I. Maiolo, E. Rodríguez, A. Lista, N. Di Virgilio, E. Cisneros, J. C. Prieto, R. affil: Special Assistance Division, Intensive Care Department, Hospital Dr. Francisco J. Muñiz, Uspallata 2272, Buenos Aires, Argentina sug: subj: HIV Infections Prognosis Meningitis, Cryptococcal Prognosis Intracranial Hypertension Therapy Human Retrospective Design Utilization Medical Records Utilization Male Female Confidence Intervals Utilization Mortality Microbial Culture and Sensitivity Tests Case Management T-Tests Utilization Fisher's Exact Test Utilization Data Analysis Software Utilization Odds Ratio Utilization Hematologic Tests Utilization Male Female ab: Purpose: To evaluate the relationship between intracranial hyperpressure (HICP) and mortality in patients with cryptococcal meningitis related to AIDS (CMRA). Methods: This was an observational retrospective study. Patients were treated according to the Infectious Diseases Society of America recommendations during the evaluation period (days 0, 3, 5 and after hospitalization). High intracranial pressure (HICP) was defined as ICP values of ≥250 mm H 20. The correlation between HICP and mortality at each of the three time points considered was investigated. Statistical analysis on the descriptive parameters and on the probability of a “death” event (odds ratio, OR) at each of those three time points was performed using the statistical software program Epidata. Results: Eighty patients were included in this study, of whom 53 (66.25 %) were male. The average age of the patients was 37.5 ± 8.1 (range 22–55) years. The median CD4+ lymphocyte cell count was 35 (range 0–367) cells/ml. Among the entire patient cohort, 53 patients had a favorable outcome, and the mortality rate was 33.75 %. At baseline (day 0), 57 subjects (71.5 %) presented HICP, and these patients had a higher mortality rate than those with a normal ICP, but the difference did not reach statistical significance [OR 1.65, 95 % confidence interval (CI) 0.56–4.84]. On day 3, 41 of the patients presented HICP, and HICP at this time point was significantly associated with an increased risk of mortality (OR 4.35, 95 % CI 1.56–12.09). On day 5, 35 (43.5 %) patients presented HICP, and HCIP at this time point was also significantly associated with higher mortality (OR 7.23, 95 % CI 2.53–20.14). Conclusion: The results of this study confirm an association between HICP and mortality in patients with CMRA and indicate that the control of ICP during the first 5 days of hospitalization is more important than managing HICP only at baseline. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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