title: CD4 count is predictive of outcome in HIV-positive patients undergoing abdominal operations.
abstract: BACKGROUND
  The impact of immune status and surgical outcome in patients with HIV and acquired immunodeficiency syndrome (AIDS) remains unknown.
  
  
  METHODS
  Clinical variables of HIV/AIDS patients undergoing abdominal surgery were examined for their impact on outcome.
  
  
  RESULTS
  Major abdominal procedures were performed in 77 patients with a diagnosis of HIV/AIDS (55 males, mean age 41.1 years, mean CD4 count 210 mg/dL). A majority of operations (53%) were performed on an urgent basis. Patients undergoing urgent procedures had lower CD4 counts (129 ± 121 vs 303 ± 324, P = .002). The mean CD4 count was lower for patients with complications (146 ± 156 vs 288 ± 319, P = .013) and for those who died (112 ± 113 vs 251 ± 283, P = .026). On multivariate analysis, CD4 count was independently associated with an increased risk for complication, and urgent operation was associated with an increased risk for mortality.
  
  
  CONCLUSIONS
  Patients with HIV/AIDS who had lower CD4 counts were more likely to require an urgent operation and experience a complication with increased mortality.
authors.affiliation: Department of Surgery, Emory University School of Medicine, Grady Memorial Hospital, Jesse Hill Jr Dr SE, Atlanta, GA 30303, USA. dfelici@emory.edu
authors.forename: Jeremiah L
authors.initials: JL
authors.lastname: Deneve
authors.forename: Jessica G
authors.initials: JG
authors.lastname: Shantha
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Page
authors.forename: Amy D
authors.initials: AD
authors.lastname: Wyrzykowski
authors.forename: Grace S
authors.initials: GS
authors.lastname: Rozycki
authors.forename: David V
authors.initials: DV
authors.lastname: Feliciano
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology; D000328:Adult; D018791:CD4 Lymphocyte Count; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D015658:HIV Infections / Q000276:immunology*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D013530:Surgical Wound Infection; D016896:Treatment Outcome