Long-term survival of patients with AIDS, Pneumocystis carinii pneumonia, and respiratory failure
Y. Friedman, C. Franklin, S. Freels and M. H. Weil
Department of Medicine, Cook County Hospital, Chicago, Ill 60612.
OBJECTIVE.--To evaluate the long-term survival of patients admitted to the
medical intensive care unit, Cook County Hospital, Chicago, Ill, with
Pneumocystis carinii pneumonia and acute respiratory failure.
DESIGN.--Cohort study over a 4-year period. SETTING.--Municipal teaching
hospital. PATIENTS.--Seventy-three consecutive patients who had 75 episodes
of P carinii pneumonia and acute respiratory failure were followed up from
the time of hospital admission until their deaths or the termination of the
study. OUTCOME MEASURES.--Duration of survival from the time of initial
hospital admission with diagnoses of P carinii pneumonia and acute
respiratory failure. RESULTS.--Consistent with recent reports of improved
short-term outcome, the immediate hospital survival was 47% (35/75). The
1-year survival was 37% (95% confidence interval, 26% to 49%). Two patients
have survived for 40 months. Almost three quarters of the patients who
survived hospitalization lived for at least 1 year. CONCLUSIONS.--The
long-term prognosis for patients with the acquired immunodeficiency
syndrome, P carinii pneumonia, and acute respiratory failure is now
substantially better than anticipated. Respiratory failure due to P carinii
pneumonia does not necessarily signify the terminal phase of human
immunodeficiency virus infection. Accordingly, patients with the acquired
immunodeficiency syndrome, P carinii pneumonia, and acute respiratory
failure can be appropriate candidates for life support in medical intensive
care units.
