Is HIV infection a risk factor for complications of surgery?

Abstract

Background: The literature is inconsistent as to whether HIV-infected patients have higher rates of surgical complication rates than HIV-uninfected patients. This inconsistency reflects the failure to control for confounding variables in many of the previous studies.

Methods: A retrospective cohort study of records of HIV-infected individuals who underwent surgical procedures between 1990 and 1995 was matched with the records of HIV-uninfected control patients. We performed a logistic regression analysis to determine the independent effects of HIV infection and other potential risk factors for surgical complications.

Results: The crude rates of death and infectious and hematologic complications were higher among HIV-infected patients than among uninfected patients. Although the crude risk of having any complication was higher among the HIV-infected (odds ratio [OR]=2.47, p=0.015), the adjusted risk was not (OR=0.72 [p<0.613]). Variables significantly associated with complications were American Society of Anesthesiology (ASA) risk class (OR=2.7), age (OR=1.06 per year), and weight (OR=0.96 per kg).

Conclusions: HIV sero-status was not found to be an independent risk factor for complications of surgery. The most important risk factor for complication of surgery in HIV-infected patients is ASA risk class.