PMID- 15544697
OWN - NLM
STAT- MEDLINE
DCOM- 20050216
LR  - 20061115
IS  - 1464-2662 (Print)
IS  - 1464-2662 (Linking)
VI  - 5
IP  - 6
DP  - 2004 Nov
TI  - Changes in hospital admissions across Europe: 1995-2003. Results from the 
      EuroSIDA study.
PG  - 437-47
AB  - OBJECTIVES: To describe changes in the proportions of patients admitted to 
      hospital and the duration of admission during the month of March between 1995 and 
      2003 and to describe the factors related to admission for 9802 patients from 
      EuroSIDA, a pan-European, observational cohort study. METHODS: Generalized 
      estimating equations were used to determine changes over time in the proportion 
      of patients admitted and the median duration of admission. Logistic regression 
      was used to determine factors related to admission in March 1995, March 1998 and 
      March 2001. RESULTS: The proportion of patients admitted during March declined 
      from 7.4% in 1995 to 2.6% in 2003. After adjustment, the estimated reduction in 
      the proportion of patients admitted was 5.5% per year [95% confidence interval 
      (CI) 2.5-8.5%; P=0.0004], a 26% reduction. The median duration of hospital 
      admission declined by 58% from 12 days in 1995 [interquartile range (IQR) 5-19 
      days] to 5 days in 2003 (IQR 3-12 days), a significant decline of 0.7 days per 
      year after adjustment (95% CI 0.5-0.9 days; P=0.031). Patients with a lower CD4 
      lymphocyte count, and with an AIDS diagnosis made within the 3 months prior to 
      March, all had increased odds of admission during March 1995, 1998 or 2001. In 
      March 2001, patients whose treatment regimen was changed as a consequence of 
      toxicities had increased odds of admission [odds ratio (OR) 2.34; 95% CI 
      1.26-4.37; P=0.0074]. In addition, patients who were hepatitis C virus-positive 
      during March 2001 (OR 1.66; 95% CI 1.02-2.68; P=0.041) had increased odds of 
      admission. CONCLUSIONS: There has been a considerable decline in both the 
      proportion of patients admitted to hospital and the median duration of the stay. 
      Patients with hepatitis C had increased odds of admission, but there was little 
      evidence of an increase in admissions among patients taking highly active 
      antiretroviral therapy (HAART) associated with serious adverse events, although 
      longer follow up is required.
FAU - Mocroft, A
AU  - Mocroft A
AD  - Royal Free Centre for HIV Medicine, Royal Free and University College Medical 
      School, London, UK. a.mocroft@pcps.ucl.ac.uk
FAU - Monforte, A d'Arminio
AU  - Monforte Ad
FAU - Kirk, O
AU  - Kirk O
FAU - Johnson, M A
AU  - Johnson MA
FAU - Friis-Moller, N
AU  - Friis-Moller N
FAU - Banhegyi, D
AU  - Banhegyi D
FAU - Blaxhult, A
AU  - Blaxhult A
FAU - Mulcahy, F
AU  - Mulcahy F
FAU - Gatell, J M
AU  - Gatell JM
FAU - Lundgren, J D
AU  - Lundgren JD
CN  - EuroSIDA study group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - HIV Med
JT  - HIV medicine
JID - 100897392
SB  - IM
MH  - Antiretroviral Therapy, Highly Active/methods
MH  - CD4 Lymphocyte Count/statistics & numerical data
MH  - Europe/epidemiology
MH  - Female
MH  - HIV Infections/complications/drug therapy/*epidemiology
MH  - Hospitalization/statistics & numerical data/*trends
MH  - Humans
MH  - Incidence
MH  - Length of Stay/statistics & numerical data/trends
MH  - Longitudinal Studies
MH  - Male
MH  - Odds Ratio
MH  - Regression Analysis
MH  - Risk Factors
MH  - Viral Load/statistics & numerical data
EDAT- 2004/11/17 09:00
MHDA- 2005/02/17 09:00
CRDT- 2004/11/17 09:00
PHST- 2004/11/17 09:00 [pubmed]
PHST- 2005/02/17 09:00 [medline]
PHST- 2004/11/17 09:00 [entrez]
AID - HIV250 [pii]
AID - 10.1111/j.1468-1293.2004.00250.x [doi]
PST - ppublish
SO  - HIV Med. 2004 Nov;5(6):437-47. doi: 10.1111/j.1468-1293.2004.00250.x.