Changes in hospital admissions across Europe

1995-2003. Results from the EuroSIDA study

A. Mocroft, A. d'Arminio Monforte, O. Kirk, M. A. Johnson, N. Friis-Moller, D. Banhegyi, A. Blaxhult, F. Mulcahy, J. M. Gatell, J. D. Lundgren, M. Losso, A. Duran, N. Vetter, N. Clumeck, S. De Wit, K. Kabeya, B. Poll, R. Colebunders, L. Machala, H. Rozsypal & 79 others J. Nielsen, C. H. Olsen, J. Gerstoft, T. Katzenstein, A. B E Hansen, P. Skinhøoj, C. Pedersen, K. Zilmer, M. Rauka, M. De Sa, J. P. Viard, T. Saint-Marc, P. Vanhems, C. Pradier, M. Dietrich, C. Manegold, J. van Lunzen, H. J. Stellbrink, V. Miller, S. Staszewski, F. D. Goebel, B. Salzberger, J. Rockstroh, R. E. Schmidt, M. Stoll, J. Kosmidis, P. Gargalianos, H. Sambatakou, J. Perdios, G. Panos, A. Filandras, I. Yust, M. Burke, S. Pollack, J. Hassoun, Z. Sthoeger, S. Maayan, S. Vella, A. Chiesi, C. Arici, R. Pristerá, F. Mazzotta, A. Gabbuti, R. Esposito, A. Bedini, A. Chirianni, E. Montesarchio, V. Vullo, P. Santopadre, P. Narciso, A. Antinori, P. Franci, M. Zaccarelli, A. Lazzarin, A. Castagna, L. Viksna, B. Rozentale, S. Chaplinskas, R. Hemmer, T. Staub, P. Reiss, J. Bruun, A. Maeland, V. Ormaasen, B. Knysz, J. Gasiorowski, A. Horban, D. Prokopowicz, A. Wiercinska-Drapalo, A. Boron-Kaczmarska, M. Pynka, M. Beniowski, H. Trocha, T. Smiatacz, F. Antunes, K. Mansinho, F. Maltez, D. Duiculescu, A. Streinu-Cercel

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Objectives. To describe changes in the proportions of patients admitted to hospital and the duration of admission during the month of March between 1995 and 2003 and to describe the factors related to admission for 9802 patients from EuroSIDA, a pan-European, observational cohort study. Methods. Generalized estimating equations were used to determine changes over time in the proportion of patients admitted and the median duration of admission. Logistic regression was used to determine factors related to admission in March 1995, March 1998 and March 2001. Results. The proportion of patients admitted during March declined from 7.4% in 1995 to 2.6% in 2003. After adjustment, the estimated reduction in the proportion of patients admitted was 5.5% per year [95% confidence interval (CI) 2.5-8.5%; P = 0.0004], a 26% reduction. The median duration of hospital admission declined by 58% from 12 days in 1995 [interquartile range (IQR) 5-19 days] to days in 2003 (IQR 3-12 days), a significant decline of 0.7 days per year after adjustment (95% CI 0.5-0.9 days; P = 0.031). Patients with a lower CD4 lymphocyte count, and with an AIDS diagnosis made within the 3 months prior to March, all had increased odds of admission during March 1995, 1998 or 2001. In March 2001, patients whose treatment regimen was changed as a consequence of toxicities had increased odds of admission [odds ratio (OR) 2.34; 95% CI 1.26-4.37; P = 0.0074]. In addition, patients who were hepatitis C virus-positive during March 2001 (OR 1.66; 95% CI 1.02-2.68; P = 0.041) had increased odds of admission. Conclusions. There has been a considerable decline in both the proportion of patients admitted to hospital and the median duration of the stay. Patients with hepatitis C had increased odds of admission, but there was little evidence of an increase in admissions among patients taking highly active antiretroviral therapy (HAART) associated with serious adverse events, although longer follow up is required.

Original languageEnglish
Pages (from-to)437-447
Number of pages11
JournalHIV Medicine
Volume5
Issue number6
DOIs
Publication statusPublished - Nov 2004

Fingerprint

Confidence Intervals
Patient Admission
Odds Ratio
Highly Active Antiretroviral Therapy
CD4 Lymphocyte Count
Hepatitis C
Hepacivirus
Observational Studies
Acquired Immunodeficiency Syndrome
Cohort Studies
Logistic Models
Therapeutics

Keywords

  • CD4
  • HAART
  • Hospital admissions

ASJC Scopus subject areas

  • Virology
  • Medicine(all)
  • Immunology

Cite this

Mocroft, A., d'Arminio Monforte, A., Kirk, O., Johnson, M. A., Friis-Moller, N., Banhegyi, D., ... Streinu-Cercel, A. (2004). Changes in hospital admissions across Europe: 1995-2003. Results from the EuroSIDA study. HIV Medicine, 5(6), 437-447. https://doi.org/10.1111/j.1468-1293.2004.00250.x

Changes in hospital admissions across Europe : 1995-2003. Results from the EuroSIDA study. / Mocroft, A.; d'Arminio Monforte, A.; Kirk, O.; Johnson, M. A.; Friis-Moller, N.; Banhegyi, D.; Blaxhult, A.; Mulcahy, F.; Gatell, J. M.; Lundgren, J. D.; Losso, M.; Duran, A.; Vetter, N.; Clumeck, N.; De Wit, S.; Kabeya, K.; Poll, B.; Colebunders, R.; Machala, L.; Rozsypal, H.; Nielsen, J.; Olsen, C. H.; Gerstoft, J.; Katzenstein, T.; Hansen, A. B E; Skinhøoj, P.; Pedersen, C.; Zilmer, K.; Rauka, M.; De Sa, M.; Viard, J. P.; Saint-Marc, T.; Vanhems, P.; Pradier, C.; Dietrich, M.; Manegold, C.; van Lunzen, J.; Stellbrink, H. J.; Miller, V.; Staszewski, S.; Goebel, F. D.; Salzberger, B.; Rockstroh, J.; Schmidt, R. E.; Stoll, M.; Kosmidis, J.; Gargalianos, P.; Sambatakou, H.; Perdios, J.; Panos, G.; Filandras, A.; Yust, I.; Burke, M.; Pollack, S.; Hassoun, J.; Sthoeger, Z.; Maayan, S.; Vella, S.; Chiesi, A.; Arici, C.; Pristerá, R.; Mazzotta, F.; Gabbuti, A.; Esposito, R.; Bedini, A.; Chirianni, A.; Montesarchio, E.; Vullo, V.; Santopadre, P.; Narciso, P.; Antinori, A.; Franci, P.; Zaccarelli, M.; Lazzarin, A.; Castagna, A.; Viksna, L.; Rozentale, B.; Chaplinskas, S.; Hemmer, R.; Staub, T.; Reiss, P.; Bruun, J.; Maeland, A.; Ormaasen, V.; Knysz, B.; Gasiorowski, J.; Horban, A.; Prokopowicz, D.; Wiercinska-Drapalo, A.; Boron-Kaczmarska, A.; Pynka, M.; Beniowski, M.; Trocha, H.; Smiatacz, T.; Antunes, F.; Mansinho, K.; Maltez, F.; Duiculescu, D.; Streinu-Cercel, A.

In: HIV Medicine, Vol. 5, No. 6, 11.2004, p. 437-447.

Research output: Contribution to journalArticle

Mocroft, A, d'Arminio Monforte, A, Kirk, O, Johnson, MA, Friis-Moller, N, Banhegyi, D, Blaxhult, A, Mulcahy, F, Gatell, JM, Lundgren, JD, Losso, M, Duran, A, Vetter, N, Clumeck, N, De Wit, S, Kabeya, K, Poll, B, Colebunders, R, Machala, L, Rozsypal, H, Nielsen, J, Olsen, CH, Gerstoft, J, Katzenstein, T, Hansen, ABE, Skinhøoj, P, Pedersen, C, Zilmer, K, Rauka, M, De Sa, M, Viard, JP, Saint-Marc, T, Vanhems, P, Pradier, C, Dietrich, M, Manegold, C, van Lunzen, J, Stellbrink, HJ, Miller, V, Staszewski, S, Goebel, FD, Salzberger, B, Rockstroh, J, Schmidt, RE, Stoll, M, Kosmidis, J, Gargalianos, P, Sambatakou, H, Perdios, J, Panos, G, Filandras, A, Yust, I, Burke, M, Pollack, S, Hassoun, J, Sthoeger, Z, Maayan, S, Vella, S, Chiesi, A, Arici, C, Pristerá, R, Mazzotta, F, Gabbuti, A, Esposito, R, Bedini, A, Chirianni, A, Montesarchio, E, Vullo, V, Santopadre, P, Narciso, P, Antinori, A, Franci, P, Zaccarelli, M, Lazzarin, A, Castagna, A, Viksna, L, Rozentale, B, Chaplinskas, S, Hemmer, R, Staub, T, Reiss, P, Bruun, J, Maeland, A, Ormaasen, V, Knysz, B, Gasiorowski, J, Horban, A, Prokopowicz, D, Wiercinska-Drapalo, A, Boron-Kaczmarska, A, Pynka, M, Beniowski, M, Trocha, H, Smiatacz, T, Antunes, F, Mansinho, K, Maltez, F, Duiculescu, D & Streinu-Cercel, A 2004, 'Changes in hospital admissions across Europe: 1995-2003. Results from the EuroSIDA study', HIV Medicine, vol. 5, no. 6, pp. 437-447. https://doi.org/10.1111/j.1468-1293.2004.00250.x
Mocroft A, d'Arminio Monforte A, Kirk O, Johnson MA, Friis-Moller N, Banhegyi D et al. Changes in hospital admissions across Europe: 1995-2003. Results from the EuroSIDA study. HIV Medicine. 2004 Nov;5(6):437-447. https://doi.org/10.1111/j.1468-1293.2004.00250.x
Mocroft, A. ; d'Arminio Monforte, A. ; Kirk, O. ; Johnson, M. A. ; Friis-Moller, N. ; Banhegyi, D. ; Blaxhult, A. ; Mulcahy, F. ; Gatell, J. M. ; Lundgren, J. D. ; Losso, M. ; Duran, A. ; Vetter, N. ; Clumeck, N. ; De Wit, S. ; Kabeya, K. ; Poll, B. ; Colebunders, R. ; Machala, L. ; Rozsypal, H. ; Nielsen, J. ; Olsen, C. H. ; Gerstoft, J. ; Katzenstein, T. ; Hansen, A. B E ; Skinhøoj, P. ; Pedersen, C. ; Zilmer, K. ; Rauka, M. ; De Sa, M. ; Viard, J. P. ; Saint-Marc, T. ; Vanhems, P. ; Pradier, C. ; Dietrich, M. ; Manegold, C. ; van Lunzen, J. ; Stellbrink, H. J. ; Miller, V. ; Staszewski, S. ; Goebel, F. D. ; Salzberger, B. ; Rockstroh, J. ; Schmidt, R. E. ; Stoll, M. ; Kosmidis, J. ; Gargalianos, P. ; Sambatakou, H. ; Perdios, J. ; Panos, G. ; Filandras, A. ; Yust, I. ; Burke, M. ; Pollack, S. ; Hassoun, J. ; Sthoeger, Z. ; Maayan, S. ; Vella, S. ; Chiesi, A. ; Arici, C. ; Pristerá, R. ; Mazzotta, F. ; Gabbuti, A. ; Esposito, R. ; Bedini, A. ; Chirianni, A. ; Montesarchio, E. ; Vullo, V. ; Santopadre, P. ; Narciso, P. ; Antinori, A. ; Franci, P. ; Zaccarelli, M. ; Lazzarin, A. ; Castagna, A. ; Viksna, L. ; Rozentale, B. ; Chaplinskas, S. ; Hemmer, R. ; Staub, T. ; Reiss, P. ; Bruun, J. ; Maeland, A. ; Ormaasen, V. ; Knysz, B. ; Gasiorowski, J. ; Horban, A. ; Prokopowicz, D. ; Wiercinska-Drapalo, A. ; Boron-Kaczmarska, A. ; Pynka, M. ; Beniowski, M. ; Trocha, H. ; Smiatacz, T. ; Antunes, F. ; Mansinho, K. ; Maltez, F. ; Duiculescu, D. ; Streinu-Cercel, A. / Changes in hospital admissions across Europe : 1995-2003. Results from the EuroSIDA study. In: HIV Medicine. 2004 ; Vol. 5, No. 6. pp. 437-447.
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title = "Changes in hospital admissions across Europe: 1995-2003. Results from the EuroSIDA study",
abstract = "Objectives. To describe changes in the proportions of patients admitted to hospital and the duration of admission during the month of March between 1995 and 2003 and to describe the factors related to admission for 9802 patients from EuroSIDA, a pan-European, observational cohort study. Methods. Generalized estimating equations were used to determine changes over time in the proportion of patients admitted and the median duration of admission. Logistic regression was used to determine factors related to admission in March 1995, March 1998 and March 2001. Results. The proportion of patients admitted during March declined from 7.4{\%} in 1995 to 2.6{\%} in 2003. After adjustment, the estimated reduction in the proportion of patients admitted was 5.5{\%} per year [95{\%} confidence interval (CI) 2.5-8.5{\%}; P = 0.0004], a 26{\%} reduction. The median duration of hospital admission declined by 58{\%} from 12 days in 1995 [interquartile range (IQR) 5-19 days] to days in 2003 (IQR 3-12 days), a significant decline of 0.7 days per year after adjustment (95{\%} CI 0.5-0.9 days; P = 0.031). Patients with a lower CD4 lymphocyte count, and with an AIDS diagnosis made within the 3 months prior to March, all had increased odds of admission during March 1995, 1998 or 2001. In March 2001, patients whose treatment regimen was changed as a consequence of toxicities had increased odds of admission [odds ratio (OR) 2.34; 95{\%} CI 1.26-4.37; P = 0.0074]. In addition, patients who were hepatitis C virus-positive during March 2001 (OR 1.66; 95{\%} CI 1.02-2.68; P = 0.041) had increased odds of admission. Conclusions. There has been a considerable decline in both the proportion of patients admitted to hospital and the median duration of the stay. Patients with hepatitis C had increased odds of admission, but there was little evidence of an increase in admissions among patients taking highly active antiretroviral therapy (HAART) associated with serious adverse events, although longer follow up is required.",
keywords = "CD4, HAART, Hospital admissions",
author = "A. Mocroft and {d'Arminio Monforte}, A. and O. Kirk and Johnson, {M. A.} and N. Friis-Moller and D. Banhegyi and A. Blaxhult and F. Mulcahy and Gatell, {J. M.} and Lundgren, {J. D.} and M. Losso and A. Duran and N. Vetter and N. Clumeck and {De Wit}, S. and K. Kabeya and B. Poll and R. Colebunders and L. Machala and H. Rozsypal and J. Nielsen and Olsen, {C. H.} and J. Gerstoft and T. Katzenstein and Hansen, {A. B E} and P. Skinh{\o}oj and C. Pedersen and K. Zilmer and M. Rauka and {De Sa}, M. and Viard, {J. P.} and T. Saint-Marc and P. Vanhems and C. Pradier and M. Dietrich and C. Manegold and {van Lunzen}, J. and Stellbrink, {H. J.} and V. Miller and S. Staszewski and Goebel, {F. D.} and B. Salzberger and J. Rockstroh and Schmidt, {R. E.} and M. Stoll and J. Kosmidis and P. Gargalianos and H. Sambatakou and J. Perdios and G. Panos and A. Filandras and I. Yust and M. Burke and S. Pollack and J. Hassoun and Z. Sthoeger and S. Maayan and S. Vella and A. Chiesi and C. Arici and R. Prister{\'a} and F. Mazzotta and A. Gabbuti and R. Esposito and A. Bedini and A. Chirianni and E. Montesarchio and V. Vullo and P. Santopadre and P. Narciso and A. Antinori and P. Franci and M. Zaccarelli and A. Lazzarin and A. Castagna and L. Viksna and B. Rozentale and S. Chaplinskas and R. Hemmer and T. Staub and P. Reiss and J. Bruun and A. Maeland and V. Ormaasen and B. Knysz and J. Gasiorowski and A. Horban and D. Prokopowicz and A. Wiercinska-Drapalo and A. Boron-Kaczmarska and M. Pynka and M. Beniowski and H. Trocha and T. Smiatacz and F. Antunes and K. Mansinho and F. Maltez and D. Duiculescu and A. Streinu-Cercel",
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month = "11",
doi = "10.1111/j.1468-1293.2004.00250.x",
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pages = "437--447",
journal = "HIV Medicine",
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TY - JOUR

T1 - Changes in hospital admissions across Europe

T2 - 1995-2003. Results from the EuroSIDA study

AU - Mocroft, A.

AU - d'Arminio Monforte, A.

AU - Kirk, O.

AU - Johnson, M. A.

AU - Friis-Moller, N.

AU - Banhegyi, D.

AU - Blaxhult, A.

AU - Mulcahy, F.

AU - Gatell, J. M.

AU - Lundgren, J. D.

AU - Losso, M.

AU - Duran, A.

AU - Vetter, N.

AU - Clumeck, N.

AU - De Wit, S.

AU - Kabeya, K.

AU - Poll, B.

AU - Colebunders, R.

AU - Machala, L.

AU - Rozsypal, H.

AU - Nielsen, J.

AU - Olsen, C. H.

AU - Gerstoft, J.

AU - Katzenstein, T.

AU - Hansen, A. B E

AU - Skinhøoj, P.

AU - Pedersen, C.

AU - Zilmer, K.

AU - Rauka, M.

AU - De Sa, M.

AU - Viard, J. P.

AU - Saint-Marc, T.

AU - Vanhems, P.

AU - Pradier, C.

AU - Dietrich, M.

AU - Manegold, C.

AU - van Lunzen, J.

AU - Stellbrink, H. J.

AU - Miller, V.

AU - Staszewski, S.

AU - Goebel, F. D.

AU - Salzberger, B.

AU - Rockstroh, J.

AU - Schmidt, R. E.

AU - Stoll, M.

AU - Kosmidis, J.

AU - Gargalianos, P.

AU - Sambatakou, H.

AU - Perdios, J.

AU - Panos, G.

AU - Filandras, A.

AU - Yust, I.

AU - Burke, M.

AU - Pollack, S.

AU - Hassoun, J.

AU - Sthoeger, Z.

AU - Maayan, S.

AU - Vella, S.

AU - Chiesi, A.

AU - Arici, C.

AU - Pristerá, R.

AU - Mazzotta, F.

AU - Gabbuti, A.

AU - Esposito, R.

AU - Bedini, A.

AU - Chirianni, A.

AU - Montesarchio, E.

AU - Vullo, V.

AU - Santopadre, P.

AU - Narciso, P.

AU - Antinori, A.

AU - Franci, P.

AU - Zaccarelli, M.

AU - Lazzarin, A.

AU - Castagna, A.

AU - Viksna, L.

AU - Rozentale, B.

AU - Chaplinskas, S.

AU - Hemmer, R.

AU - Staub, T.

AU - Reiss, P.

AU - Bruun, J.

AU - Maeland, A.

AU - Ormaasen, V.

AU - Knysz, B.

AU - Gasiorowski, J.

AU - Horban, A.

AU - Prokopowicz, D.

AU - Wiercinska-Drapalo, A.

AU - Boron-Kaczmarska, A.

AU - Pynka, M.

AU - Beniowski, M.

AU - Trocha, H.

AU - Smiatacz, T.

AU - Antunes, F.

AU - Mansinho, K.

AU - Maltez, F.

AU - Duiculescu, D.

AU - Streinu-Cercel, A.

PY - 2004/11

Y1 - 2004/11

N2 - Objectives. To describe changes in the proportions of patients admitted to hospital and the duration of admission during the month of March between 1995 and 2003 and to describe the factors related to admission for 9802 patients from EuroSIDA, a pan-European, observational cohort study. Methods. Generalized estimating equations were used to determine changes over time in the proportion of patients admitted and the median duration of admission. Logistic regression was used to determine factors related to admission in March 1995, March 1998 and March 2001. Results. The proportion of patients admitted during March declined from 7.4% in 1995 to 2.6% in 2003. After adjustment, the estimated reduction in the proportion of patients admitted was 5.5% per year [95% confidence interval (CI) 2.5-8.5%; P = 0.0004], a 26% reduction. The median duration of hospital admission declined by 58% from 12 days in 1995 [interquartile range (IQR) 5-19 days] to days in 2003 (IQR 3-12 days), a significant decline of 0.7 days per year after adjustment (95% CI 0.5-0.9 days; P = 0.031). Patients with a lower CD4 lymphocyte count, and with an AIDS diagnosis made within the 3 months prior to March, all had increased odds of admission during March 1995, 1998 or 2001. In March 2001, patients whose treatment regimen was changed as a consequence of toxicities had increased odds of admission [odds ratio (OR) 2.34; 95% CI 1.26-4.37; P = 0.0074]. In addition, patients who were hepatitis C virus-positive during March 2001 (OR 1.66; 95% CI 1.02-2.68; P = 0.041) had increased odds of admission. Conclusions. There has been a considerable decline in both the proportion of patients admitted to hospital and the median duration of the stay. Patients with hepatitis C had increased odds of admission, but there was little evidence of an increase in admissions among patients taking highly active antiretroviral therapy (HAART) associated with serious adverse events, although longer follow up is required.

AB - Objectives. To describe changes in the proportions of patients admitted to hospital and the duration of admission during the month of March between 1995 and 2003 and to describe the factors related to admission for 9802 patients from EuroSIDA, a pan-European, observational cohort study. Methods. Generalized estimating equations were used to determine changes over time in the proportion of patients admitted and the median duration of admission. Logistic regression was used to determine factors related to admission in March 1995, March 1998 and March 2001. Results. The proportion of patients admitted during March declined from 7.4% in 1995 to 2.6% in 2003. After adjustment, the estimated reduction in the proportion of patients admitted was 5.5% per year [95% confidence interval (CI) 2.5-8.5%; P = 0.0004], a 26% reduction. The median duration of hospital admission declined by 58% from 12 days in 1995 [interquartile range (IQR) 5-19 days] to days in 2003 (IQR 3-12 days), a significant decline of 0.7 days per year after adjustment (95% CI 0.5-0.9 days; P = 0.031). Patients with a lower CD4 lymphocyte count, and with an AIDS diagnosis made within the 3 months prior to March, all had increased odds of admission during March 1995, 1998 or 2001. In March 2001, patients whose treatment regimen was changed as a consequence of toxicities had increased odds of admission [odds ratio (OR) 2.34; 95% CI 1.26-4.37; P = 0.0074]. In addition, patients who were hepatitis C virus-positive during March 2001 (OR 1.66; 95% CI 1.02-2.68; P = 0.041) had increased odds of admission. Conclusions. There has been a considerable decline in both the proportion of patients admitted to hospital and the median duration of the stay. Patients with hepatitis C had increased odds of admission, but there was little evidence of an increase in admissions among patients taking highly active antiretroviral therapy (HAART) associated with serious adverse events, although longer follow up is required.

KW - CD4

KW - HAART

KW - Hospital admissions

UR - http://www.scopus.com/inward/record.url?scp=9244257277&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=9244257277&partnerID=8YFLogxK

U2 - 10.1111/j.1468-1293.2004.00250.x

DO - 10.1111/j.1468-1293.2004.00250.x

M3 - Article

VL - 5

SP - 437

EP - 447

JO - HIV Medicine

JF - HIV Medicine

SN - 1464-2662

IS - 6

ER -