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. 2015 Feb;473(2):581-6.
doi: 10.1007/s11999-014-3855-8.

Does HIV infection increase the risk of perioperative complications after THA? A nationwide database study

Qais Naziri  1 , Matthew R Boylan, Kimona Issa, Lynne C Jones, Harpal S Khanuja, Michael A Mont
Affiliations

Does HIV infection increase the risk of perioperative complications after THA? A nationwide database study

Qais Naziri et al. Clin Orthop Relat Res. 2015 Feb.

Abstract

Background: Recent studies have shown successful midterm outcomes after total hip arthroplasty (THA) in patients with human immunodeficiency virus (HIV). However, little data exist on the epidemiology, risk of perioperative complications, and length of stay in patients with HIV receiving THA.

Questions/purposes: The purposes of this study were to assess (1) the demographic trends of patients with HIV who underwent primary THA; (2) the differences in the risk of major and minor perioperative complications among patients with and without HIV; and (3) the differences in mean length of hospital stay among patients with and without HIV.

Methods: The Nationwide Inpatient Sample was used to compare patients with and without HIV who were admitted for THA between 1998 and 2010 in the United States. We extracted data on each admission's age, sex, race, insurance, and comorbidities. The study population consisted of 2,656,696 patients without HIV and 9275 patients with HIV.

Results: Patients with HIV were more likely to be younger, be male, not pay with Medicare, and be of a nonwhite race. After controlling for confounding variables, patients with HIV were more likely to have major complications (2.9% [266 of 9275] versus 2.7% [71,952 of 2,656,696]; odds ratio [OR], 1.47; 95% confidence interval [CI], 1.08-2.00; p=0.014) and minor complications (5.2% [483 of 9275] versus 4.8% [127,940 of 2,656,696]; OR, 1.61; 95% CI, 1.29-2.02; p<0.001) compared with patients who did not have HIV. Patients undergoing THA who had HIV also had an increased length of hospital stay compared with patients without HIV (4.31 versus 3.83 days, p<0.001).

Conclusions: Given these findings, we believe orthopaedic surgeons should be aware of the potential for longer and more complicated hospital stays after THA among patients with HIV. However, the modest increase in risk of adverse outcomes does not cause us to recommend against THA for patients with HIV who otherwise meet reasonable surgical indications. Future studies should explore the relationships between markers of HIV severity and risk of adverse outcomes after THA during the hospital stay and followup.

Level of evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Figures

Fig. 1
Fig. 1
The annual number of admissions with complications per 1000 THA admissions, according to HIV status, is shown.
Fig. 2
Fig. 2
The annual mean length of stay of THA admissions, according to HIV status, is shown.
See this image and copyright information in PMC

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References

    1. Blanco F, San Roman J, Vispo E, Lopez M, Salto A, Abad V, Soriano V. Management of metabolic complications and cardiovascular risk in HIV-infected patients. AIDS Rev. 2010;12:231–241. - PubMed
    1. Capogna BM, Lovy A, Blum Y, Kim SJ, Felsen UR, Geller DS. Infection rate following total joint arthroplasty in the HIV population. J Arthroplasty. 2013;28:1254–1258. doi: 10.1016/j.arth.2012.12.021. - DOI - PubMed
    1. Elixhauser A, Steiner C, Harris DR, Coffey RM. Comorbidity measures for use with administrative data. Med Care. 1998;36:8–27. doi: 10.1097/00005650-199801000-00004. - DOI - PubMed
    1. Gandhi RT, Sax PE, Grinspoon SK. Metabolic and cardiovascular complications in HIV-infected patients: new challenges for a new age. J Infect Dis. 2012;205(Suppl 3):S353–S354. doi: 10.1093/infdis/jis202. - DOI - PMC - PubMed
    1. Glidden DV, Shiboski SC, McCulloch CE. Linear Regression: Checking Model Assumptions and Fit. Regression Methods in Biostatistics: Linear, Logistic, Survival, and Repeated Measures Models. New York, NY, USA: Springer-Verlag; 2011.

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