Felicitas Roembke and Hauke Heinzow equally contributed.
Clinical outcome and predictors of survival in patients with pneumocystis jirovecii pneumonia – results of a tertiary referral centre
Version of Record online: 1 OCT 2013
© 2013 John Wiley & Sons Ltd
The Clinical Respiratory Journal
Volume 8, Issue 1, pages 86–92, January 2014
How to Cite
Roembke, F., Heinzow, H. S., Gosseling, T., Heinecke, A., Domagk, D., Domschke, W. and Meister, T. (2014), Clinical outcome and predictors of survival in patients with pneumocystis jirovecii pneumonia – results of a tertiary referral centre. The Clinical Respiratory Journal, 8: 86–92. doi: 10.1111/crj.12042
Roembke F and Heinzow HS contributed equally to this work; Roembke F: design of the study, analysis and interpretation of data, drafting of the manuscript; Heinzow HS: analysis and interpretation of data, drafting of the manuscript, technical and material support; Achim Heinecke: supervision of statistical analysis; Gosseling T: acquisition and analysis of data; Domagk D: critical revision of the manuscript for important intellectual content, technical support; Domschke W: revision of the manuscript for important intellectual content; Meister T: senior author, study concept and design, analysis and interpretation of data, drafting of the manuscript, statistical analysis, study supervision, final approval of the version to be published.
The present study has been reviewed by the local ethics committee and has been performed in accordance with the ethical standards laid down in the 2000 Declaration of Helsinki.
Conflict of interest
The authors have stated explicitly that there are no conflicts of interest in connection with this article.
Potential competing interests
- Issue online: 6 JAN 2014
- Version of Record online: 1 OCT 2013
- Accepted manuscript online: 15 JUL 2013 03:06AM EST
- Manuscript Accepted: 9 JUL 2013
- Manuscript Revised: 19 JUN 2013
- Manuscript Received: 21 JAN 2013
- pneumocystis pneumonia;
- predictors of survival
Background and Aims
Pneumocystis jirovecii pneumonia also known as pneumocystis pneumonia (PCP) is an opportunistic respiratory infection in human immunodeficiency virus (HIV) patients that may also develop in non-HIV immunocompromised persons. The aim of our study was to evaluate mortality predictors of PCP patients in a tertiary referral centre.
Fifty-one patients with symptomatic PCP were enrolled in the study. The patients had either HIV infection (n = 21) or other immunosuppressive conditions (n = 30). Baseline characteristics (e.g. age, sex and underlying disease) were retrieved. Kaplan–Meier analysis was employed to calculate survival. Comparisons were made by log-rank test. A multivariate analysis of factors influencing survival was carried out using the Cox regression model. Chi-squared test and Wilcoxon–Mann–Whitney test was applied as appropriate.
The median survival time for the HIV group was >120 months compared with 3 months for the non-HIV group (P = 0.009). Three-month survival probability was also significantly greater in the HIV group compared with the non-HIV group (90% vs 41%, P = 0.002). In univariate log-rank test, intensive care unit (ICU) necessity, HIV negativity, age >50 years, haemoglobin <10g/dl, C-reactive protein >5 mg/dL and multiple comorbidities were significant negative predictors of survival. In the Cox regression model, ICU and HIV statuses turned out to be independent prognostic factors of survival.
PCP is a serious problem in non-HIV immunocompromised patients in whom survival outcomes are worse than those in HIV patients.