Preoperative Risk Factors Influencing the Incidence of Postoperative Sepsis in Human Immunodeficiency Virus-Infected Patients: A Retrospective Cohort Study

• Published in: World journal of surgery 2013-04, Vol.37 (4), p.774-779
• Main Authors: Su, Jinsong, Tsun, Andy, Zhang, Lei, Xia, Xianjun, Li, Bin, Guo, Ruizhang, Liu, Baochi
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adult; Aged; Albumin Level; Binary Logistic Regression Analysis; Biomarkers - blood; Cardiac Surgery; CD4 Lymphocyte Count; Cohort Studies; Female; General Surgery; HIV Infections - blood; HIV Infections - complications; HIV Infections - immunology; Human Immunodeficiency Virus; Humans; Incidence; Logistic Models; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Preoperative Period; Retrospective Studies; Risk Factors; Sepsis - epidemiology; Sepsis - etiology; Serum Albumin - metabolism; Surgery; Surgical Infection; Surgical Wound Infection - complications; Systemic Inflammatory Response Syndrome; Thoracic Surgery; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-013-1915-y

Background Compared to noninfected patients, human immunodeficiency virus (HIV)-infected patients undergoing surgery have an increased postoperative risk of developing sepsis. We aimed to investigate the preoperative risk factors that affect the incidence of sepsis after surgery in HIV-infected patients. Methods Clinical parameters of 215 patients with HIV/acquired immunodeficiency syndrome (AIDS) who had undergone surgery between January 2011 and February 2012 were examined retrospectively for the effect of HIV/AIDS on the incidence of postoperative sepsis. Results Logistic regression analysis identified four independent risk factors of postoperative sepsis in HIV-infected patients: CD4 counts [B = −0.007, odds ratio (OR) 0.993]; blood albumin levels (B = −0.077, OR 0.926); surgical infection (B = 1.887, OR 6.598); major surgery (B = 1.013, OR 2.754). The incidence of postoperative sepsis was high with CD4 counts ≤ 100 cells/μl, albumin levels 350 cells/μl, the incidence of postoperative sepsis was significantly lower (16.36%, 9/55). Conclusions Low CD4 cell counts, hypoalbuminemia, surgical infection, and major surgery are independent risk factors for the development of postoperative sepsis among HIV-infected patients. CD4 cell numbers and albumin levels negatively correlated with the incidence of postoperative sepsis, whereas surgical infections and major surgical procedures positively correlated with the incidence of postoperative sepsis.