Causas de óbito em pacientes com síndrome da imunodeficiência adquirida, necropsiados na Fundação de Medicina Tropical do Amazonas / Causes of death among patients with acquired immunodeficiency syndrome autopsied at the Tropical Medicine Foundation of Amazonas

RESUMO

O objetivo deste estudo foi verificar em 129 pacientes com AIDS, necropsiados na Fundação de Medicina Tropical do Amazonas de 1996 a 2003, as causas do óbito, observando o grau de concordância entre os diagnósticos necroscópicos com os diagnósticos clínicos. A doença mais freqüente que causou o óbito foi tuberculose 28 por cento, seguida de pneumonia bacteriana 17 por cento, histoplasmose 13 por cento, toxoplasmose 10 por cento, pneumocistose 8 por cento, criptococose 5 por cento, sepse bacteriana 4 por cento e 15 por cento outras causas. A concordância entre o diagnóstico clínico antemortem e a necropsia foi de 51,9 por cento. O principal órgão acometido foi o pulmão 82,2 por cento. O tempo de sobrevivência após o diagnóstico laboratorial até o óbito variou entre um mês e 120 meses. A média de sobrevivência foi 15 dias e 56 por cento morreram menos de um mês após o diagnóstico, 15 pacientes morreram na mesma data do diagnóstico. Esses resultados demonstram a importância da necropsia na causa mortis em pacientes com AIDS.

ABSTRACT

The aim of this study was to investigate the causes of death among 129 AIDS patients that were autopsied at the Tropical Medicine Foundation of Amazonas between 1996 and 2003. The degree of concordance between the autopsy diagnoses and the clinical diagnoses was observed. The disease that most frequently caused death was tuberculosis (28 percent), followed by bacterial pneumonia (17 percent), histoplasmosis (13 percent), toxoplasmosis (10 percent), pneumocystosis (8 percent), cryptococcosis (5 percent), bacterial sepsis (4 percent) and other causes (15 percent). The concordance between the clinical diagnosis before death and the autopsy was 51.9 percent. The main organ involved was the lungs (82.2 percent). The length of survival from the time of the laboratory diagnosis to death ranged from one month to 120 months. The mean length of survival was 15 days and 56 percent died less than one month after the diagnosis, while 15 patients died on the same day that they were diagnosed. These results show the importance of autopsies in elucidating the causes of death among AIDS patients.