Hospitalization Outcomes in Pneumocystis Pneumonia Inpatient Population: A Comparison between HIV and Non-HIV Patients

Abstract

Objective To evaluate the difference in hospitalization outcomes, including morbidity and mortality among patients admitted for Pneumocystis pneumonia (PCP) with human immunodeficiency virus (HIV) and non-HIV condition. Methods A case-control study was done using the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) data. We identified PCP and HIV as the primary and secondary diagnosis using ICD-9--CM diagnosis codes. We used the multinomial logistic regression model to generate odds ratios (OR). Results A total number of 1250 PCP patients were enrolled in this retrospective analysis. PCP patients with HIV had eight times higher odds of non-elective admission based on emergency condition (OR = 7.873, P < .001) compared to non-HIV patients. PCP patients with HIV had eight times higher odds of longer hospitalization of more than eight days (OR = 8.687, P < .001) compared to non-HIV patients. HIV patients with PCP had five times higher odds of severe morbidity or extreme loss of body function (OR = 5.277, P < .001). PCP patients with HIV had 22 times higher likelihood of in-hospital mortality (OR = 21.845, P < .001) compared to non-HIV patients. Conclusion PCP patients with HIV have a higher risk of severe morbidity and in-hospital mortality as compared to non-HIV patients. More attention needs to be paid to the elderly population that is at a higher risk of PCP with HIV. We need additional research and studies to direct the development of clinical care models for aiming early diagnosis and treatment of HIV in PCP patients.