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Treatment of immigrants and residents suffering from Neuro-Aids on a neurological intensive care unit: epidemiology and predictors of outcome

Abstract

This study aimed at determining the clinical features and predictors for the outcome of patients with Neuro-Aids treated on a neurological intensive care unit (NICU) using retrospective analysis of all patients treated for Neuro-Aids in a tertiary Department of Neurology between 1996 and 2011. Chart review of the patients including the characteristics of intensive care was performed. As negative outcome, “death on the NICU or within 2 months following completion of NICU treatment” was defined. In total, 462 patients were identified of whom 87 were immigrants. 67 of all patients required NICU treatment (mean age 40.2 ± 0.8 years; 64 % male). The median of the duration between diagnosis of HIV infection and the onset of treatment on NICU was 8 days for immigrants and 10 years for residents (p < 0.001). 34 of the patients on the NICU died due to severe neuromanifestations. Negative predictors for death were: (1) artificial ventilation; (2) antiretroviral-naïve immigrant; (3) primary cerebral lymphoma; (4) missing antiretroviral therapy upon admission to the NICU. Gender, age, ethnicity, CD4+ cell count, and viral load were no predictors of a negative outcome. The results indicated that the rate of death during treatment on a NICU is much higher as compared with treatment on an internal medicine ICU. A lot of research and effort will be necessary to improve this outcome especially for immigrants with Neuro-Aids.

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Conflict of interest

Braicks: none; Reichelt: Expert’s fees from Boehringer, GSK, Gilead, Roche; Evers: Grants and expert’s fees from Allergan, Berlin Chemie, Boehringer, Desitin, Dysport, Eisai, GSK, MSD, Novartis, Pfizer, UCB, Weber and Weber; Husstedt: Advisory Board of Boehringer, BMS, Abbott; expert’s fees from von Astra, Boehringer, BMS, GSK, Gilead, Pfizer, Grünenthal, MSD, Behring, research grant from Gilead for investigator-initiated study.

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Correspondence to I. W. Husstedt.

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Husstedt, I.W., Braicks, O., Reichelt, D. et al. Treatment of immigrants and residents suffering from Neuro-Aids on a neurological intensive care unit: epidemiology and predictors of outcome. Acta Neurol Belg 113, 391–395 (2013). https://doi.org/10.1007/s13760-013-0185-7

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  • DOI: https://doi.org/10.1007/s13760-013-0185-7

Keywords

  • Predictors of outcome
  • Neuro-Aids
  • Neurological intensive care unit
  • Residents
  • Immigrants