Couppie et al evaluated risk factors associated with 30 day mortality in AIDS patients receiving antifungal therapy for disseminated histoplasmosis. This can help identify patients who may require more aggressive therapy and closer monitoring. The authors are from multiple hospitals in French Guiana.
Risk factors identified by Couppie et al:
(1) dyspnea (respiratory rate of > 20 breaths per minute, with respiratory distress)
(2) thrombocytopenia with platelet count < 100,000 per µL
(3) serum LDH greater than 2 times the upper limit of the normal reference range
Risk factors previously identified:
(1) hypotension
(2) impaired mental status
(3) severe malnutrition with hypoalbuminemia
(4) respiratory failure requiring intubation (probably redundant if dyspnea used)
(5) renal insufficiency
Most of these factors reflect an organ failure, with mortality increasing as the number of system failures increase.
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