Complications of common gynecologic surgeries among HIV-infected women in the United States.
OBJECTIVE
To compare frequencies of complications among HIV-infected and-uninfected women undergoing common gynecological surgical procedures in inpatient settings.


METHODS
We used 1994-2007 data from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project, a nationally representative sample of inpatient hospitalizations. Our analysis included discharge records of women aged ≥15 undergoing hysterectomy, oophorectomy, salpingectomy for ectopic pregnancy, bilateral tubal sterilization, or dilation and curettage. Associations between HIV infection status and surgical complications were evaluated in multivariable logistic regression models, adjusting for key covariates.


RESULTS
For each surgery, HIV infection was associated with experiencing ≥1 complication. Adjusted ORs ranged from 2.0 (95% confidence interval (CI): 1.7, 2.2) for hysterectomy with oophorectomy to 3.1 (95% CI: 2.4, 4.0) for bilateral tubal sterilization with no comorbidity present. HIV infection was positively associated with extended length of stay and infectious complications of all of the surgeries examined. For some surgeries, it was positively associated with transfusion and anemia due to acute blood loss. Among HIV-infected women, the odds of infectious and other complications did not decrease between 1994-2000 and 2001-2007.


CONCLUSIONS
HIV infection was associated with elevated frequencies of complications of gynecologic surgeries in the US, even in the era of HAART.
National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. bpv4@cdc.gov
Ana
A
Penman-Aguilar
Maura K
MK
Whiteman
Shanna
S
Cox
Samuel F
SF
Posner
Susan F
SF
Meikle
Athena P
AP
Kourtis
Denise J
DJ
Jamieson
D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000453:epidemiology; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D015658:HIV Infections; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology*; D013530:Surgical Wound Infection / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult