POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS DISEASE - CLINICAL-DATA AND A LITERATURE-REVIEW

Objective: To compare complications after and outcome from surgical pr ocedures between patients with human immunodeficiency virus (HIV) dise ase and a matched control population. Design: Retrospective case revie w. Setting: 476-bed university tertiary care center. Patients: Of 343 patients diagnosed as having HIV disease between 1981 and September 19 91, 26 (7.6 percent) were Walter Reed classifications system 3B or gre ater and underwent a surgical procedure with general anesthesia or, in the case of 2 patients, regional anesthesia, at the study hospital. T hese patients were matched to 26 control patients by severity of illne ss according to APACHE II severity of illness score and by age, sex, r ace, and anesthetic regimen. Measurements and Results: The postoperati ve occurrence of dysrhythmia, hypotension, hypoxia, hemorrhage, renal insufficiency, or infection was evaluated in the study and control gro ups. Deaths within 3 and 30 days of the procedure and duration of surv ival after discharge from the hospital were recorded. Frequency of com plications and 3- and 30-day mortality did not differ between the 2 gr oups. Duration of survival after discharge from the hospital in patien ts with HIV disease (7.4 +/- 9.7 months) was approximately 25 percent that in control patients (30.6 +/- 35.9 months) (p = 0.02). Conclusion s: HIV disease does not increase the risk of postprocedural complicati ons, including death, up to 30 days postprocedure. Thereafter, patient s with HIV disease classified by the Walter Reed System as greater-tha n-or-equal-to 3B may survive for a shorter time than do equally ill pa tients who do not have HIV disease. Thus, needed surgical intervention should not be limited based on HIV status and concern for subsequent complications.