The Impact of Asymptomatic Human Immunodeficiency Virus-Positive Disease Status on Inpatient Complications Following Spine Surgery: A Propensity Score-Matched Analysis

Abstract

In the United States, nearly 1.2 million people > 12 years old have human immunodeficiency virus (HIV), which is associated with postoperative complications following orthopedic procedures. Little is known about how asymptomatic HIV (AHIV) patients fare postoperatively. This study compares complications after common spine surgeries between patients with and without AHIV. The Nationwide Inpatient Sample (NIS) was retrospectively reviewed from 2005–2013, identifying patients aged > 18 years who underwent 2–3-level anterior cervical discectomy and fusion (ACDF), ≥4-level thoracolumbar fusion (TLF), or 2–3-level lumbar fusion (LF). Patients with AHIV and without HIV were 1:1 propensity score-matched. Univariate analysis and multivariable binary logistic regression were performed to assess associations between HIV status and outcomes by cohort. 2–3-level ACDF (n = 594 total patients) and ≥4-level TLF (n = 86 total patients) cohorts demonstrated comparable length of stay (LOS), rates of wound-related, implant-related, medical, surgical, and overall complications between AHIV and controls. 2–3-level LF (n = 570 total patients) cohorts had comparable LOS, implant-related, medical, surgical, and overall complications. AHIV patients experienced higher postoperative respiratory complications (4.3% vs. 0.4%,). AHIV was not associated with higher risks of medical, surgical, or overall inpatient postoperative complications following most spine surgical procedures. The results suggest the postoperative course may be improved in patients with baseline control of HIV infection.

Fracture‐related wound infections following surgical treatment of fractures in HIV‐positive and HIV‐negative patients: A meta‐analysis

“…14 examinations published between 1991 and 2023 were included in the meta-analysis because they fit the inclusion criteria following a review of 1056 relevant examinations. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] of them were HIV-positive, and 2462 were HIVnegative. The sample size was 14-646 personals.…”

“…14 examinations published between 1991 and 2023 were included in the meta‐analysis because they fit the inclusion criteria following a review of 1056 relevant examinations 6–19 . Table 2 summarizes the findings of these investigations.…”

“…The sample size was 14-646 personals. [6][7][8][9][10][11][12][13][14][15][16][17][18][19] The examined data revealed that HIV-positive had significantly higher FAWI before antiretroviral compared to HIV-negative personals with fractures. However, no significant difference was found between HIV-positive and HIV-negative in FAWI after antiretroviral in personals with fractures.…”

“…14 examinations from 1991 to 2023 were recruited for the current analysis including 3528 personals with fractures were in the utilized examinations' starting point, 1066 of them were HIV‐positive, and 2462 were HIV‐negative. The sample size was 14–646 personals 6–19 . The examined data revealed that HIV‐positive had significantly higher FAWI before antiretroviral compared to HIV‐negative personals with fractures.…”