The Effect of Human-Immunodeficiency Virus Status on Outcomes in Penetrating Abdominal Trauma: An Interim Analysis

World J Surg. 2018 Aug;42(8):2412-2420. doi: 10.1007/s00268-018-4502-4.

Abstract

Background: The purpose of this study was to determine whether the outcomes of hemodynamically stable patients undergoing exploratory laparotomy for penetrating abdominal trauma differed as a result of their HIV status.

Methods: This was an observational, prospective study from February 2016 to May 2017. All hemodynamically stable patients with penetrating abdominal trauma requiring a laparotomy were included. The mechanism of injury, the HIV status, age, the penetrating abdominal trauma index (PATI), and the revised trauma score (RTS) were entered into a binary logistic regression model. Outcome parameters were in-hospital death, morbidity, admission to intensive care unit (ICU), relaparotomy within 30 days, and length of stay longer than 30 days.

Results: A total of 209 patients, 94% male, with a mean age of 29 ± 10 years were analysed. Twenty-eight patients (13%) were HIV positive. The two groups were comparable. Ten (4.8%) laparotomies were negative. There were two (0.96%) deaths, both in the HIV negative group. The complication rate was 34% (n = 72). Twenty-nine patients (14%) were admitted to the ICU. A higher PATI, older age, and a lower RTS were significant risk factors for ICU admission. After 30 days, 12 patients (5.7%) were still in hospital. Twenty-four patients (11%) underwent a second laparotomy. The PATI score was the single independent predictor for complications, relaparotomy, and hospital stay longer than 30 days.

Conclusions: Preliminary results reveal that HIV status does not influence outcomes in patients with penetrating abdominal trauma.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Abdominal Injuries / complications
  • Abdominal Injuries / surgery*
  • Acquired Immunodeficiency Syndrome / complications
  • Adult
  • CD4 Lymphocyte Count
  • Female
  • HIV Seronegativity*
  • HIV Seropositivity / complications*
  • Humans
  • Laparotomy / adverse effects
  • Length of Stay
  • Logistic Models
  • Male
  • Postoperative Complications
  • Prospective Studies
  • Treatment Outcome
  • Wounds, Penetrating / complications
  • Wounds, Penetrating / surgery*