2024, Number 5
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Arch Med Fam 2024; 26 (5)
Prolonged Hospitalization: the Crucial Impact on Hospitalization for HIV/AIDS. A Retrospective Cohort Analysis in Brazil between 2019 and 2022
Pacheco FM, Levites MR
Language: Portugués
References: 19
Page: 237-242
PDF size: 192.37 Kb.
ABSTRACT
The present paper is a cohort study carried out in an
infectious disease reference center in a tertiary hospital
in the city of São Paulo, which investigated the
relationship between some variables and the outcome
of death in patients living with HIV/AIDS hospitalized
in a given period. In addition to epidemiology,
the work highlighted the importance of the topic for
preventive medicine, including pre- and post-exposure
prophylaxis. The results showed a heterogeneous
population, predominantly young, with emphasis on
the most frequent symptoms and diagnoses. The statistical
analysis revealed that, in addition to the TCD4
lymphocyte count, prolonged hospitalization has a
statistically significant association with the occurrence
of death. The findings highlight the importance of
implementing preventive measures to improve clinical
outcomes and reduce morbidity and mortality
associated with HIV/AIDS, especially in prolonged
hospitalizations. This study emphasizes the need for
a comprehensive and effective approach to managing
these patients, aiming to improve institutional rates.
Furthermore, the study promotes reflection on the
need for quality control strategies and reducing patients’
length of stay, and extrapolates the reflection
to hospitalizations for all causes, seeking alternatives
for early dehospitalization, such as back-up or transition
hospitals.
REFERENCES
UNAIDS Brasil. Estatísticas [Internet]. UNAIDS Brasil.Disponível em: https://unaids.org.br/estatisticas/.
US Preventive Services Task Force. Preexposure Prophylaxisfor the Prevention of HIV Infection: RecommendationStatement. JAMA [Internet]. 2019 Jun11;321(22):2203-13. Disponível em: https://jamanetwork.com/journals/jama/fullarticle/2730540.
Ministério da Saúde (BR). Protocolo Clínico e DiretrizesTerapêuticas - Profilaxia Pós-Exposição de Risco (PEP)à Infecção pelo HIV, Infecções Sexualmente Transmissíveis(IST) e Hepatites Virais. Brasília: Ministérioda Saúde; 2022.
Ministério da Saúde (BR). Protocolo Clínico e DiretrizesTerapêuticas para Profilaxia Pré-Exposição (PrEP)de Risco à Infecção pelo HIV. Brasília: Ministério daSaúde; 2022.
Ministério da Saúde (BR). Nota Técnica Nº 8/2023da Coordenação-Geral de Vigilância do HIV/AIDS edas Hepatites Virais (CGAHV), do Departamento deDoenças de Condições Crônicas e Infecções SexualmenteTransmissíveis (DCCI), da Secretaria de Vigilânciaem Saúde (SVS), do Ministério da Saúde. Brasília:Ministério da Saúde; 2023.
Ministério da Saúde (BR). Secretaria de Vigilância emSaúde e Ambiente. Departamento de HIV/AIDS, Tuberculose,Hepatites Virais e Infecções SexualmenteTransmissíveis. Brasília, DF: Ministério da Saúde;2022
Focaccia R, Ribeiro ML, Cossich AC, Andrade RF, CarbonariKF, Kallouf GA, et al. Clinical and epidemiologyevaluation of Aids-infected patients hospitalized between2011 and 2016 in the Santos region of Brazil.Rev Soc Bras Med Trop. 2019;52.
Grinsztejn B, Veloso VG, Friedman RK, Moreira RI, LuzPM, Campos DP, et al. Early mortality and cause of deathsin patients using HAART in Brazil and the UnitedStates. AIDS. 2009 Oct;23(16):2107-14.
Nascimento L, Improta-Caria AC, Brites C. Mortality inhospitalized HIV-infected patients in a referral centerin Bahia, Brazil. The Brazilian Journal of Infectious Diseases.2022 Nov;26(6):102716.
Roque KE, Tonini T, Melo ECP. Adverse events in theintensive care unit: impact on mortality and length ofstay in a prospective study. Cadernos de Saúde Pública.2016 Oct;32(10).
Haukland EC, Mevik K, von Plessen C, Nieder C, VonenB. Contribution of adverse events to death ofhospitalised patients. BMJ Open Quality. 2019 Feb;8(1):e000377.
Ofori-Asenso R, Liew D, Mårtensson J, Jones D. TheFrequency of, and Factors Associated with ProlongedHospitalization: A Multicentre Study in Victoria, Australia.JCM. 2020 Sep 22;9(9):3055.
Beck DH, McQuillan P, Smith GB. Waiting for thebreak of dawn? Intensive Care Medicine. 2002 Aug1;28(9):1287–93.
Charais C, Bowers M, Do OO, Smallheer B. Implementationof a Disease Management Program inAdult Patients With Heart Failure. Prof Case Manag.2020 Nov/Dec;25(6):312-323. doi: 10.1097/NCM.0000000000000413. PMID: 33017366.
Albert N. M. (2016). A systematic review of transitional-care strategies to reduce rehospitalization in patientswith heart failure. Heart & Lung, 45(2), 100–113.doi:10.1016/j.hrtlng.2015.12.001
Burke R. E., Guo R., Prochazka A. V., Misky G. J. (2014).Identifying keys to success in reducing readmissionsusing the ideal transitions in care framework.BMC Health Services Research, 14(423), 1–10.doi:10.1186/1472-6963-14-423
Hansen L. O., Young R. S., Hinami K., Leung A., WilliamsM. V. (2011). Interventions to reduce 30-dayrehospitalization: A systematic review. Annals of InternalMedicine, 155(8), 520–528. doi:10.7326/0003-4819-155-8-201110180-00008
Zou D, Wang L, Li J, Li L, Wei X, Huang L. The benefitsof transitional care in older patients with chronic diseases:a systematic review and meta-analysis. AgingClinical and Experimental Research. 2021 Oct 14.
Jackson CT, Trygstad TK, DeWalt DA, DuBard CA. TransitionalCare Cut Hospital Readmissions For North CarolinaMedicaid