Abstract
PURPOSE: The aim of this study was to assess the outcomes and risk factors for in-hospital mortality and further explore a predictive model for forecasting in-hospital mortality in HIV-positive patients with sepsis. METHODS: A retrospective cohort study of 203 hospitalized HIV-positive patients with sepsis was conducted at Chongqing Public Health Medical Center, a tertiary-level infectious disease hospital, from January 2021 to December 2023. Patients were divided into two groups according to survival status (survival and death). The patients' baseline characteristics, laboratory findings and outcomes were collected for comprehensive analysis. RESULTS: The in-hospital mortality rate was 18.7%. Independent risk factors for in-hospital mortality in HIV-positive patients with sepsis were acute respiratory failure (OR 3.654, 95% CI 1.303-10.248, p = 0.014), septic shock (OR 9.542, 95% CI 3.614-25.197, p < 0.001), chronic liver disease (OR 4.330, 95% CI 1.348-13.910, p = 0.014) and lactate (OR 1.570, 95% CI 1.195-2.062, p = 0.001). The AUC for the RF model to predict in-hospital death was 0.853, and the threshold was -1.553 with a sensitivity of 73.7% and a specificity of 84.8%. CONCLUSIONS: Acute respiratory failure, septic shock, chronic liver disease and lactate were independent risk factors for in-hospital mortality in HIV-positive patients with sepsis. The prediction model based on these four risk factors demonstrated good effectiveness in predicting in-hospital mortality among HIV-positive patients with sepsis.