Supplemental Table 1. VACS Risk Index and weights of variables
Characteristic Points
Age (in years) <50 0
50-64 12
≥ 65 27
CD4 cell count (cells/ml) ≥ 500 0
350-499 6 200-349 6 100-199 10
50-99 28
<50 29
HIV RNA (log copies/ml) <500 0
500-10,000 7
>10,000 14
Hemoglobin (g/dl) ≥ 14 0
12-13.9 10 10-11.9 22
<10 38
FIB 4 ratio <1.45 0
1.45-3.25 6
>3.25 25
eGFR (ml/min) >60 0
45-59.9 6 30-44.9 8
<30 26
Hepatits C coinfection 5
Supplemental Table 2. ICD-9 codes used for disease category grouping at MICU admission.
Disease Category ICD-9 Codes
Respiratory 460.00-519.99
Infection 001.00-139.99 (excluding 042 for HIV) 995.91-995.94
996.64 999.3
HIV 042 Cardiovascular 390.00-429.99 GI and liver 520.00-579.99
Endocrine 240.00-279.99 Neurologic 320.00-389.99
430.00-459.99
Renal 580.00-608.00 Non-AIDS Cancer 140.00-239.99
Other Any other ICD-9 code not included above
Supplemental Table 3. ICD-10 codes for HIV related cause of death B200 HIV disease resulting in mycobacterial infection B201 HIV disease resulting in other bacterial infections B202 HIV disease resulting in cytomegaloviral disease B203 HIV disease resulting in other viral infections B204 HIV disease resulting in candidiasis
B205 HIV disease resulting in other mycoses
B206 HIV disease resulting in Pneumocystis carinii pneumonia B207 HIV disease resulting in multiple infections
B208 HIV disease resulting in other infectious and parasitic diseases B209 HIV disease resulting in unspecified infectious or parasitic disease B210 HIV disease resulting in Kaposis sarcoma
B211 HIV disease resulting in Burkitts lymphoma
B212 HIV disease resulting in other types of non-Hodgkins lymphoma
B213 HIV disease resulting in other malignant neoplasms of lymphoid, haematopoietic and related tissue
B217 HIV disease resulting in multiple malignant neoplasms B218 HIV disease resulting in other malignant neoplasms B219 HIV disease resulting in unspecified malignant neoplasm B220 HIV disease resulting in encephalopathy
B222 HIV disease resulting in wasting syndrome
B227 HIV disease resulting in multiple diseases classified elsewhere B231 HIV disease resulting in (persistent) generalized lymphadenopathy
B232 HIV disease resulting in haematological and immunological abnormalities, not elsewhere classified
B238 HIV disease resulting in other specified conditions B24 Unspecified human immunodeficiency virus [HIV] disease
Supplemental Table 4. Characteristics and outcomes for patients with at least one VA MICU admisison by HIV status. (N=678)
Characteristic HIV-infected (n=386) Uninfected (n=292)
Age in years at MICU admission, median (IQR) 54 (48, 58) 56 (52, 62)
Male gender, n (%) 381 (99) 285 (98)
Race, n (%)
White 56 (15) 68 (23)
Black 285 (74) 186 (64)
Hispanic 30 (8) 21 (7)
Other 15 (4) 17 (6)
HIV-specific variables
CD4 cell count in cells/mm3, median (IQR) 277 (114, 496)
N/A HIV RNA non-detectable (<500 copies/ mm3), n (%)a 194 (53) N/A HIV RNA in log10 copies/ml, median (IQR) 2.6 (1.9, 4.4) N/A ART use within 90 days of MICU admission, n (%) 282 (73) N/A Baseline comorbidities diagnosed prior to MICU admission
Smoking status, n (%)
Never 64 (17) 39 (13)
Current 220 (57) 150 (51)
Former 102 (26) 103 (35)
Hazardous alcohol use, n (%) 179 (46) 168 (58)
Hypertension, n (%) 218 (57) 232 (80)
Diabetes mellitus, n (%) 108 (28) 144 (49)
History of pneumonia, n (%) 87 (23) 22 (8)
CAD, n (%) 42 (11) 68 (23)
CHF, n (%) 22 (6) 39 (13)
Cancer history, n (%)b 69 (18) 43 (15)
Chronic obstructive pulmonary disease, n (%) 56 (15) 66 (23)
Hepatitis B coinfection, n (%) 41 (11) 12 (4)
Hepatitis C coinfection, n (%) 237 (61) 116 (40)
Opportunistic infections during hospitalization 56 (15) N/A
Pneumocystis pneumonia 28 (7) N/A
Candidiasis 24 (6) N/A
All other c 18 (5) N/A
VACS Index score at MICU admission, median (IQR)d 76 (55, 96) 42 (28, 60) Length of stay and mechanical ventilation
MICU length of stay, median (IQR) 2 (1, 4) 2 (1, 3)
Hospital length of stay, median (IQR) 6.5 (3, 12) 4 (2, 8)
Mechanical ventilation, n (%) 49 (13) 16 (6)
Reason for hospitalization, (%)e
Respiratory 81 (21) 35 (12)
Infection 35 (9) 7 (2)
HIV 45 (12) N/A
Cardiovascular 77 (20) 87 (30)
GI and liver 39 (9) 35 (12)
Endocrine 22 (6) 26 (9)
Neurologic 10 (3) 20 (7)
Renal 22 (6) 5 (2)
Non-AIDS Cancer b 14 (4) 10 (3)
Other 89 (23) 67 (23)
30-day mortality, n (%) 69 (18) 27 (9)
MICU=medical intensive care unit
IQR=interquartile range; 25% and 75% quartiles included.
CAD= cardiovascular disease
CHF= congestive heart failure ART=antiretroviral therapy
N/A=not applicable except for MICU and hospital length of stay where N/A=not available for Medicare MICU admission.
a Among those with HIV viral load within 6 months prior to MICU admission.
b Excludes ICD9 codes for Kaposi sarcoma, non-Hodgkin lymphoma, squamous and basal cell carcinoma of the skin.
c No more than 5 of any other opportunistic infections.
d VACS Index scores calculated assuming normal CD4 cell counts and undetectable viral load. Available for 92% of HIV+ and 80% of uninfected patients admitted to VA MICUs.
e MICU principal diagnosis with 90% agreement with hospital principal diagnosis.
