Cumming, K, Tiamkao, S, Kongbunkiat, K, Clark, AB, Bettencourt-Silva, JH, Sawanyawisuth, K, Kasemsap, N, Mamas, MA ORCID: 0000-0001-9241-8890, Seeley, JA and Myint, PK (2017) Impact of HIV on inpatient mortality and complications in stroke in Thailand; A National Database Study. Epidemiology and Infection, 145 (6). pp. 1285-1291. ISSN 1469-4409

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Abstract

The co-existence of stroke and HIV has increased in recent years, but the impact of HIV on post-stroke outcomes is poorly understood. We examined the impact of HIV on inpatient mortality, length of acute hospital stay and complications (pneumonia, respiratory failure, sepsis and convulsions), in hospitalized strokes in Thailand. All hospitalized strokes between 1 October 2004 and 31 January 2013 were included. Data were obtained from a National Insurance Database. Characteristics and outcomes for non-HIV and HIV patients were compared and multivariate logistic and linear regression models were constructed to assess the above outcomes. Of 610 688 patients (mean age 63·4 years, 45·4% female), 0·14% (866) had HIV infection. HIV patients were younger, a higher proportion were male and had higher prevalence of anaemia (P < 0·001) compared to non-HIV patients. Traditional cardiovascular risk factors, hypertension and diabetes, were more common in the non-HIV group (P < 0·001). After adjusting for age, sex, stroke type and co-morbidities, HIV infection was significantly associated with higher odds of sepsis [odds ratio (OR) 1·75, 95% confidence interval (CI) 1·29–2·4], and inpatient mortality (OR 2·15, 95% CI 1·8–2·56) compared to patients without HIV infection. The latter did not attenuate after controlling for complications (OR 2·20, 95% CI 1·83–2·64). HIV infection is associated with increased odds of sepsis and inpatient mortality after acute stroke.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Cambridge University Press at https://doi.org/10.1017/S095026881600340X Please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: complications, HIV, mortality, stroke, outcomes
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > Institute for Applied Clinical Sciences
Depositing User: Symplectic
Date Deposited: 12 Jan 2017 09:35
Last Modified: 22 Jun 2018 09:28
URI: http://eprints.keele.ac.uk/id/eprint/2758

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