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Long-term Survival of Patients With AIDS, Pneumocystis carinii Pneumonia, and Respiratory Failure
Yaakov Friedman, MD;
Cory Franklin, MD;
Sally Freels, PhD;
Max Harry Weil, MD, PhD
JAMA. 1991;266(1):89-92.
Abstract
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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.
(JAMA. 1991;266:89-92)
Author Affiliations
From the Division of Critical Care Medicine, Department of Medicine, Cook County Hospital, Chicago, Ill (Drs Friedman and Franklin); and the University of Health Sciences, The Chicago Medical School, North Chicago, Ill (Drs Friedman, Franklin, and Weil); and the Department of Epidemiology-Biostatistics, School of Public Health, University of Illinois at Chicago (Dr Freels).
Footnotes
Presented at the annual American Thoracic Society Conference, Boston, Mass, May 21, 1990.
Reprint requests to Medical Intensive Care Unit, Cook County Hospital, 1835W Harrison St, Chicago, IL 60612 (Dr Friedman).
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