Postoperative complications in patients with human immunodeficiency virus disease. Clinical data and a literature review.
OBJECTIVE
To compare complications after and outcome from surgical procedures between patients with human immunodeficiency virus (HIV) disease and a matched control population.


METHODS
Retrospective case review.


METHODS
476-bed university tertiary care center.


METHODS
Of 343 patients diagnosed as having HIV disease between 1981 and September 1991, 26 (7.6 percent) were Walter Reed classifications system 3B or greater and underwent a surgical procedure with general anesthesia or, in the case of 2 patients, regional anesthesia, at the study hospital. These patients were matched to 26 control patients by severity of illness according to APACHE II severity of illness score and by age, sex, race, and anesthetic regimen.


RESULTS
The postoperative occurrence of dysrhythmia, hypotension, hypoxia, hemorrhage, renal insufficiency, or infection was evaluated in the study and control groups. Deaths within 3 and 30 days of the procedure and duration of survival after discharge from the hospital were recorded. Frequency of complications and 3- and 30-day mortality did not differ between the 2 groups. Duration of survival after discharge from the hospital in patients with HIV disease (7.4 +/- 9.7 months) was approximately 25 percent that in control patients (30.6 +/- 35.9 months) (p = 0.02).


CONCLUSIONS
HIV disease does not increase the risk of postprocedural complications, including death, up to 30 days postprocedure. Thereafter, patients with HIV disease classified by the Walter Reed System as > or = 3B may survive for a shorter time than do equally ill patients who do not have HIV disease. Thus, needed surgical intervention should not be limited based on HIV status and concern for subsequent complications.
Ayers
J
J
Department of Anesthesiology, University of Florida College of Medicine, Gainesville.
Howton
M J
MJ
Layon
A J
AJ
D000328:Adult; D000758:Anesthesia; D003422:Critical Care; D005260:Female; D015658:HIV Infections; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index