HIV-1 infection and cardiothoracic surgery: the difference in attitudes between consultants and junior surgeons in the United Kingdom.
A postal survey was carried out inviting the opinions of consultant and trainee cardiothoracic surgeons on the subject of operating upon patients who are either HIV-1 antibody positive or suffer from full-blown AIDS. The questionnaire contained both cardiac and thoracic clinical situations, all of which under normal circumstances would be managed surgically with low operative mortality and long median survival. The overall response rate was 72.4%. A significantly greater number of consultants replied compared to juniors, 80% and 51.6%, respectively (P less than 0.001). In both groups, surgeons were more likely to operate upon a patient who was HIV-1 antibody positive than one who had AIDS. There were no significant differences in the replies of consultants and juniors to the clinical scenarios presented. However, a greater number of juniors admitted to modifying their surgical practice in the light of the increasing incidence of HIV-1 infection (P less than 0.001). Routine preoperative HIV antibody testing was advocated by 77.8% of consultants and 75% of juniors and this rose to 95.1% and 97%, respectively, if patients were in the traditionally high risk groups. Four consultants admitted that they were already performing routine preoperative HIV antibody screening. This survey emphasized the real concern amongst cardiothoracic surgeons, irrespective of their grade, about HIV-1 infection and the need for both education and clear policy guidelines to deal with this difficult issue.
Shah
S S
SS
Department of Cardiothoracic Surgery, Royal Brompton National Heart and Lung Hospital, London, UK.
Roxburgh
J C
JC
Loveday
C
C
Goldstraw
P
P
Yacoub
M H
MH
D000163:Acquired Immunodeficiency Syndrome / Q000523:psychology*; D001294:Attitude to Health; D003253:Consultants / Q000523:psychology*; D015658:HIV Infections / Q000523:psychology; D006679:HIV Seropositivity / Q000523:psychology; D015497:HIV-1; D006801:Humans; D008505:Medical Staff, Hospital / Q000523:psychology*; D009784:Occupational Diseases / Q000517:prevention & control; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D013903:Thoracic Surgery; D006113:United Kingdom