Patients with human immunodeficiency virus infection admitted to the emergency department of a general hospital

Background: The description of the demographic, toxicologic, immunologic and clinicopathologic characteristics of patients with known human immunodeficiency virus infection (HIV) admitted to hospital through the emergency department is presented. Methods: A cohort study of patients with known HIV seropositivity who consecutively attended the emergency department of the Hospital del Mar in Barcelona, Spain, from January to March 1995 and who required hospitalization with follow up until discharge from hospital was performed. From the clinical history of each patient the following parameters were analyzed: age, sex, domicile, toxicologic history, risk factors for HIV infection, epidemiologic and pathologic history, CD4 lymphocyte count, clinical stage, the complementary tests carried out, as well as the diagnosis on admission and hospital discharge. Results: During the study period, 6,379 patients were attended in the emergency department, 323 of whom corresponded to HIV seropositive patients. Of 1,460 admissions, 126 (77 males [61%] and 49 females [39%]) corresponded to known HIV patients, of whom 75.5% were or had been intravenous drug addicts. Eighty-three point three percent were from the health care area assigned to the hospital. According to the AIDS clinical stage, 26 (20.6%) belonged to group A, 14 (11.1%) to group B and 86 (68.2%) to group C. The complementary tests performed were: thorax radiography in 80%, abdomen radiography in 4%, cerebral computerized axial tomography (CAT) in 9.5%, lumbar punction in 5%, thoracocentesis in 3%, paracentesis in 4% and clinical analysis in 95%. The most frequent cause of admission was pulmonary disease (40%) with 21.5% corresponding to tuberculosis. Homogenesis among diagnoses on admission and discharge was 75%. Conclusions: The high percentage of hospitalary admissions in known HIV patients requiring medical attention in the emergency department is of note. The patients are usually from the health care area of the center, belong to group C, require a high number of complementary tests with pulmonary disease being the most frequent cause of admission.