Predictors of operative outcome in patients with human immunodeficiency virus infection and acquired immunodeficiency syndrome

Tran, Hoang S.; Moncure, Michael; Tarnoff, Michael; Goodman, Martin; Puc, Matthew; Kroon, David; Eydelman, Julia; Ross, Steven E.

doi:10.1016/s0002-9610(00)00450-5

Cited by 60 publications

(44 citation statements)

References 24 publications

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“…Furthermore, decrement in percent of CD4+ T cell proved to be the independent predictors of postoperative complications [9]. In the present study, …”

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confidence: 57%

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Trends of HIV-infected Patients Operated at Single Hospital

Kwon

Kim

et al. 2014

Korean J Nosocomial Infect Control

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Background:As anti-retroviral therapy has improved and the life expectancy of patients' with HIV in Korea has increased, an increased number of surgical procedures have been performed in this population. Therefore, in the current study, we investigated the trend in surgery conducted on patients with HIV in our hospital over the last 5 years. Methods: We retrospectively reviewed the medical records of HIV-infected patients who underwent surgery under general or local anesthesia at our hospital between 2005 and 2010. Results: The total number of surgeries performed in HIV-infected patients in the 5-year period was 95. Of these, 23 (24%) were performed under general anesthesia and 72 (76%) under spinal anesthesia. Anorectal surgery was the most commonly performed surgery (71 cases, 76%). The postoperative complication rate was 5.3% (3 cases of pneumonia and 2 of wound infection), with general anesthesia and time to discharge being identified as contributory factors. Preoperative CD4+ T cell count was not significantly associated with complications. Conclusion: This study was the first to analyze the trends in surgical procedures performed in HIV-infected patients in Korea. Our study may be beneficial as a reference for clinicians who manage patients with HIV.

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“…Furthermore, decrement in percent of CD4+ T cell proved to be the independent predictors of postoperative complications [9]. In the present study, …”

supporting

confidence: 57%

“…However, several studies show that low CD4+ T cell counts are associated with poor clinical outcomes in HIV patients [8,9]. Lin et al [8] reported that low CD4+…”

mentioning

confidence: 99%

Trends of HIV-infected Patients Operated at Single Hospital

Kwon

Kim

et al. 2014

Korean J Nosocomial Infect Control

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“…Six did not show any predictive value 13,15,[22][23][24][25] and 3 found that a low CD4 count was a predictor of a poor outcome. [26][27][28] Though four of the five deaths in HIV positive group had CD4 counts < 200 cells/mm 3 , many patients with similar low counts successfully underwent surgery. The heterogeneity of the population studied in this cohort and the small number of deaths makes comment on the value of CD4 count, as a prognostic or management tool, speculative.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of HIV Status and CD4 Counts in a Surgical Cohort: Their Relationship to Clinical Outcome

Čačala

Mafana

Thomson

et al. 2006

annals

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INTRODUCTION HIV positivity alone as a predictor of surgical outcome has not been extensively studied in regions of high prevalence. The aim was to determine the prevalence of HIV infection in surgical patients, and compare differences in their clinical course based on their serological status and CD4 counts. PATIENTS AND METHODS A prospective cohort of 350 patients, enrolled over 6 weeks, were studied. HIV status was determined in all patients. HIV-positive patients had CD4 counts. Clinical details were collated with HIV data after completion of enrolment. RESULTS Of the 350 patients, all but 6 were black South Africans. The median age was 31 years (range, 18–82 years). There were 143 trauma and 207 non-trauma patients. The male:female ratio was 1.4:1. The overall HIV seropositivity rate was 39% (females, 46%; males, 36%). Overall, 228 patients had surgical intervention and 96 patients had drainage of sepsis. The hospital stay (HIV negative, 11.9 ± 15.9 days; HIV positive, 11.0 ± 15 days) and mortality (HIV positive, 3.6%; HIV negative, 3.7%) did not differ by major diagnostic category. For HIV-positive patients, the male:female ratio was 1.2:1. There were 54 trauma and 83 non-trauma patients. An operation for the drainage of a septic focus was commoner in the HIV-positive admissions. Thirty-two (24%) patients had CD4 counts less than 200 cells/mm3, (i.e. AIDS). The hospital mortality, hospital stay and severity of sepsis were not related to CD4 counts. CONCLUSIONS HIV status does not influence the outcome of general surgical admissions and should not influence surgical management decisions. In HIV-positive surgical patients, CD4 counts have no relation to in-hospital outcome in a heterogeneous group of surgical patients.

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“…Although profound immunodeficiency is associated with poor prognosis, asymptomatic HIV-infected patients recover well from surgery and do not appear to suffer delayed healing 6,7 . Yet, with new antiviral therapy the operative mortality has dropped as much as necessary for emergency abdominal surgery and the riskbenefit analysis is now more in favour of laparotomy 5,8,9 .…”

Section: Introductionmentioning

confidence: 99%