1. 14th European AIDS Conference
Abstract Nr PE 12/12
Is changing pattern of mortality altering the proportion of HIV-positive patients dying in HIV hospital? - data from Polish Observational Cohort of HIV/AIDS Patients (POLCA) study
A. Chylak-Nowosielska1, J. Kowalska1,2, J. Kubicka3, E. Firląg-Burkacka3, A. Horban1,2 for the POLCA Study Group
1. Hospital of Infectious Diseases in Warsaw, Warsaw, Poland, 2. Medical University of Warsaw, Department of Adults Infectious Diseases, Warsaw, Poland, 3. Hospital of Infectious Diseases in Warsaw, HIV Out-Patient Clinic, Warsaw, Poland
Background
Combination antiretroviral therapy has significantly changed the pattern of mortality in HIV-positive population.
With increasing burden of non-AIDS-morbidity it’s expected that more patients would be admitted to non-HIV hospitals resulting in decreasing of HIV hospital deaths.
Methods
POLCA is observational cohort study initiated in 1994
Laboratory data and complete antiretroviral treatment history are collected in real-time from clinic database.
All clinical events are peer-reviewed.
Deaths are collected and reviewed using Coding Causes of Death (CoDe) standads
Current analyses included data collected from 1st January 2002 until 30th September 2012
Patients were followed from enrollment into the study until last visit or death.
Identification of hospital deaths was performed through HIV hospital’s electronic database.
Crude mortality rates were calculated per 1000 population and stratified by year.
Chi-square and Kruskal-Wallis tests were used for group comparisons.
Conclusions
The observed mortality rates are similar to those reported by other cohorts.
The proportion of deaths that occurred in hospital hasn’t substantially changed in the last ten years.
This may suggest HIV patients are referred to HIV hospital despite the diagnosis of severe non-HIV condition.
In order to provide equality in access to care further insight into cause-specific mortality is needed.
Acknowledgments
research grant received from Fundation for Research Support in Hospital for Infectious Diseases, Warsaw, Poland
Results
234 of 3087 patients died during PYFU, which presents crude mortality rate of 75.8 per 1000.
19.7 % patients were female, median age was (IQR ). Baseline characteristics are shown in table 1.
63 (26.9%) patients died in HIV hospital (9 at the ICU).
The proportion of hospital deaths over calendar year varied from 9.1% to 47.1%, but didn’t significantly change over time (p=0.24).
Autopsy has been performed in 4 cases.
According to death certificates only 4 deaths were due to non-AIDS-related cause.
POLCA Study Group:
Od Joasi K.