Chest
Clinical InvestigationsPostoperative Complications in Patients With Human Immunodeficiency Virus Disease: Clinical Data and a Literature Review
Section snippets
Study Population
The records of all patients with HIV disease or AIDS who had been cared for at our hospital, a 476-bed tertiary care university medical center, from 1981 through September 1991 were reviewed. Patients' records were identified by a computer search for the 1CD-9 diagnostic code (International Classification of Diseases, 9th edition) for the terms AIDS, immune deficiency, acquired immune deficiency, Pneumocystis carinii pneumonia, AIDS-related complex, and HIV disease. HIV disease was diagnosed by
RESULTS
Between 1981 and September 1991, HIV disease was diagnosed in 343 patients (Table 1). Data from 55 who were ≤13 years of age and 12 who were pregnant and admitted for vaginal delivery without general anesthesia were excluded from the study. Of the remaining 276, 24 were categorized under the Walter Reed system as class 3B or greater and underwent a surgical procedure with general anesthesia; 2 patients underwent a major surgical procedure with regional anesthesia. These 26, who comprised 14
DISCUSSION
Because the only basis for medical judgments about treatment should be whether it is effective and benefits the patient,25 we performed this study to determine whether morbidity and mortality differ between patients with advanced HIV disease and those without HIV disease but an illness of similar severity, when both groups undergo a surgical procedure. If HIV disease were associated with an increased risk from surgical procedures, this could indicate that different surgical guidelines for these
ACKNOWLEDGMENTS
This work was supported in part by a grant from the Foundation for Anesthesia Education and Research. Lynn Dirk provided editorial assistance. Joseph W. Shands, Jr., M.D., provided critical and thoughtful commentary.
References (0)
Cited by (0)
This research was supported in part by the Foundation for Anesthesia Education and Research. Ms. Ayers was partly funded by a fellowship from the Medical Student Research Program of the National Institutes of Health, grant 5-T35-HL07489.
Presented in part at the 82nd Annual Scientific Assembly, Southern Medical Association, New Orleans, November 6-9, 1988.
Manuscript received June 29; revision accepted October 15