| Objective(s): Opportunistic infection is an important factor leading to the death of AIDS patients and seriously affects the survival and quality of life of patients.Based on the data of HIV/AIDS opportunistic infection inpatients from Yunnan Infectious Disease Hospital,this study investigated the factors influencing the survival prognosis of HIV/AIDS opportunistic infection inpatients,established a nomogram prediction model for survival prognosis,and evaluated it by AUC and calibration curve.To screen high-risk patients and put forward targeted measures to reduce mortality,so as to provide reference for the prevention and control of HIV-related opportunistic infections in Chinese inpatients.Methods: A total of 1299 patients admitted to Yunnan Provincial Infectious Disease Hospital and diagnosed as HIV opportunistic infection from January 1,2019 to December 31,2021 were included in the study.The survival of the hospitalized patients was followed up.The clinical characteristics of the patients were analyzed,and then randomly divided into the training set and the validation set according to a ratio of 7:3.Univariate Cox proportional risk regression analysis was performed on the training set.Correlation analysis was performed on statistically significant variables and included in Lasso analysis.A nomogram prediction model was constructed for statistically significant variables in Cox proportional hazard regression analysis based on clinical experience.AUC and calibration curve were used to evaluate the model,and risk stratification was performed according to cut-off values of the nomogram risk score.Results: Among 1299 hospitalized patients with HIV opportunistic infection,630cases(48.50%)in 2019,417 cases(32.10%)in 2020,and 252 cases(19.40%)in2021.A total of 55 cases(4.23%)were discharged by death,21 cases(1.62%)in2019,24 cases(1.85%)in 2020,and 10 cases(0.77%)were discharged by death in2021.A total of 321 cases(24.71%)died by December 2022.Of the 321 deaths,230 had multiple opportunistic HIV infections as the primary diagnosis at the time of discharge.Hospitalized patients with HIV and opportunistic infection often present multiple clinical symptoms.The most common reasons for medical treatment were fever in 489 cases(37.64%),cough in 312 cases(24.02%),sputum in 250 cases(19.25%),chest tightness in 59 cases(4.54%),chest pain in 32 cases(2.46%),abdominal pain in 28 cases(2.16%),diarrhea in 23 cases(1.77%),headache in 35cases(2.69%),and mouth There were 133 cases of leukoplakia(10.24%),158 cases of fatigue(12.16%)and 115 cases of rash(8.85%).The main causes of death were infection in 66 cases(5.08%),tuberculosis in 5 cases(0.38%),cardiovascular disease in 22 cases(1.69%),tumor in 20 cases(1.54%),respiratory disease in 25 cases(1.92%),non-AIDS death in 46 cases(3.54%),including suicide in 15 cases(1.15%).122 cases(9.39%)could not be determined.There were 761 cases(58.58%)of multiple infections,676 cases(52.04%)of tuberculosis,199 cases(15.32%)of pneumospore pneumonia,151 cases(11.62%)of Marniffei basket bacteria,97 cases(7.47%)of cytomegalovirus infection,112 cases(8.62%)of herpes.There were 95cases(7.31%)of cryptococcus infection,45 cases(3.46%)of non-tuberculous mycobacterium infection,and 2 cases(0.15%)of hepatitis B infection.The analysis shows that: Age and ALB are important factors affecting the prognosis of hospitalized patients with AIDS opportunistic infection.Combined with clinical experience,the survival prediction model of hospitalized patients with AIDS opportunistic infection was constructed.AUC 0.695 and 0.704(P=0.698)were plotted in the training set and validation set.Hosmer-Lemeshow test results show that this nomogram has good predictive value and good calibration ability.According to the cut-off results of the scoring model,the risk stratification was carried out,and the inpatients with HIV opportunistic infection were divided into high risk group and low risk group.At the same time,multiple opportunistic infections of HIV,PCP and tuberculosis were analyzed respectively.The results showed that this nomogram model had good prediction ability.Conclusions: In this study,the clinical manifestations of opportunistic HIV infection were diverse.The most common first symptom was fever,the most common opportunistic infection was tuberculosis,and the main cause of death was multiple infections.Age and ALB are important factors affecting the prognosis of hospitalized patients with AIDS opportunistic infection.The prediction model of AIDS opportunistic infection inpatients has a high degree of differentiation and clinical effectiveness,and has certain value for accurate prevention and individual health management of AIDS opportunistic infection inpatients. |
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