Trends of HIV-infected Patients Operated at Single Hospital

Young Kwon Mi; Rum Kim Mi; Kim Jieun; Hee Kim Gunn

doi:10.14192/kjnic.2014.19.1.15

Journal List > Korean J Nosocomial Infect Control > v.19(1) > 1098341

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Mi, Mi, Jieun, and Gunn: Trends of HIV-infected Patients Operated at Single Hospital

Original Article

J Nosocomial Infect Control 2013;19(1):15-19.

Published online: 3 May 2013

DOI: https://doi.org/10.14192/kjnic.2014.19.1.15

Trends of HIV-infected Patients Operated at Single Hospital

Young Kwon Mi, Rum Kim Mi, Kim Jieun, Hee Kim Gunn

Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea

Address reprint requests to Gunn Hee Kim, Department of Anesthesiology and Pain Medicine, National Medical Center, 245, Euljiro, Jung-gu, Seoul 100-799, Korea Tel: 02-2260-7374, Fax: 02-2262-7258 E-mail: ipsse@dreamwiz.com

Received 6 May 2013 Accepted 11 December 2013

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

As anti-retroviral therapy has improved and the life expectancy of patients’ with HIV in Korea has increased, an increased number of surgical procedures have been performed in this population. Therefore, in the current study, we investigated the trend in surgery conducted on patients with HIV in our hospital over the last 5 years.

Methods

We retrospectively reviewed the medical records of HIV-infected patients who underwent surgery under general or local anesthesia at our hospital between 2005 and 2010.

Results

The total number of surgeries performed in HIV-infected patients in the 5-year period was 95. Of these, 23 (24%) were performed under general anesthesia and 72 (76%) under spinal anesthesia. Anorectal surgery was the most commonly performed surgery (71 cases, 76%). The postoperative complication rate was 5.3% (3 cases of pneumonia and 2 of wound infection), with general anesthesia and time to discharge being identified as contributory factors. Preoperative CD4+ T cell count was not significantly associated with complications.

Conclusion

This study was the first to analyze the trends in surgical procedures performed in HIV-infected patients in Korea. Our study may be beneficial as a reference for clinicians who manage patients with HIV.

Keywords: Acquired immunodeficiency syndrome, HIV, Operation

References

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Fig. 1.

Surgery incidences according to age and sex in 95 HIV-infected patients.

Table 1.

The nature of operation

Operations	No. of patients	Operation name	No. of patients	Anesthesia	Postoperative complication
Anorectal	71	Fistulectomy, Anal abscess incision & drainage	14	Spinal	None
		Condyloma excision	53	Spinal	None
		Hemorroidectomy	4	Spinal	None
Abdominal	10	Exploratory-laparotomy	3	General	Wound infection (1)
		Colostomy	1	General	Wound infection (1)
		Wound closure	1	General	None
		Hernia repair	2	General	None
		Appendectomy	2	General	None
		Lymph node biopsy	1	General	None
Orthopedic	7	Fracture of extremities	3	General	None
		Arthroscopic surgery of knee	1	Spinal	None
		Spine surgery	3	General	None
Neurosurgery	3	Craniectomy	2	General	Pneumonia (2)
		Stereotactic aspiration	1	General	Pneumonia (1)
Thoracic surgery	1	Video assisted thoracoscopy	1	General
ENT	1	Tympanic membrane surgery	1	General	None
OBGY	2	Cesarean section	1	General	None
		Electrosurgical excision procedure	1	General	None

Abbreviations: ENT, ear-nose-throat department surgery; OBGY, obstetric and gynecological department surgery.

Table 2.

The nature of anesthesia

Type of anesthesia	General	Spinal	P-value
No. of patients	23	72
No. of complications/total (%)
CD4+ä200	2/6 (33.3)	0/11 (0)	ä 0.001
CD4+≥200	3/17 (17.6)	0/61 (0)	ä 0.001
Duration of discharge	21.823.2	2.75.8	ä 0.001
(days, meansSD)

Abbreviations: CD4+ä200, CD4+ T cell count ä200 cells/mm³; CD4+≥200, CD4+ T cell count ≥200 cells/mm³.

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