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CD4 count is predictive of outcome in HIV-positive patients undergoing abdominal operations

Authors
Journal
The American Journal of Surgery
0002-9610
Publisher
Elsevier
Publication Date
Volume
200
Issue
6
Identifiers
DOI: 10.1016/j.amjsurg.2010.07.030
Keywords
  • Hiv
  • Acquired Immunodeficiency Syndrome
  • Immune Status
  • Cd4
  • Abdominal Surgery
Disciplines
  • Medicine

Abstract

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. Conclusion Patients with HIV/AIDS who had lower CD4 counts were more likely to require an urgent operation and experience a complication with increased mortality.

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