HUMAN-IMMUNODEFICIENCY-VIRUS AND THE TRAUMA PATIENT - FACTORS INFLUENCING POSTOPERATIVE INFECTIOUS COMPLICATIONS

Objective: While immunosuppression 2 degrees to human immunedeficiency virus (HIV) infection should logically render HIV+ trauma victims mor e prone to infection after injury, little data is available regarding trauma outcome in this group of patients, Since the helper CD4+ lympho cyte count is a marker for progression of HIV-associated diseases, me examined the relationship between CD4+ counts, Injury Severity Score ( ISS), and bacterial infectious complications in HIVC trauma patients, Method: Retrospective review of 56 consecutive HIV+ trauma patients tr eated at a Level I trauma center, Results: Nine patients (15%) develop ed significant infectious complications (four pneumonias, three soft-t issue infections, one urinary tract infection, one wound infection) wi th no pattern to the causative agents, Evaluation of CD4+ counts, whit e blood cell counts, serum albumin levels, blood transfusion requireme nts, and ISS revealed that only the ISS was associated with infectious complications, Conclusion: Despite the profound immunosuppression in this group of patients, the incidence of bacterial infectious complica tions was independent of the CD4+ count (p = 0.958), but was associate d with increases in the ISS (p = 0.003).