Prognostic Indicators in Patients with the Acquired Immune Deficiency Syndrome (AIDS) and Respiratory Infection

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Abstract
The records of 63 patients with acquired immune deficiency syndrome (AIDS) and respiratory infection comprising 78 hospitalizations over a 36-month period were reviewed to ascertain the etiology of the respiratory infection and to identify the factors influencing short-term survival. Pneumocystis carinii pneumonia (PCP) was diagnosed on 56 occasions in 46 patients. Fifty percent of patients with PCP died with respiratory failure; of these, all but 1 were diagnosed using fiber-optic bronchoscopy. In 18 patients in whom PCP was not identified by bronchoscopy, the in-hospital mortality was 17%. Of the clinical and laboratory findings on admission, only the arterial PO2 and the alveolar-arterial PO2 (AaPO2) difference were significantly between the survivors and nonsurvivors. In patients with PCP and a AaPO2 > 60 mmHg, 92% died. The demonstration of P. carinii by fiber-optic bronchoscopy and the presence of markedly abnormal gas exchange are associated with high in-hospital mortality.