Conference Coverage

HIV not a risk factor for postappendectomy complications




JACKSONVILLE, FLA. – Patients who have HIV are at no greater risk of complications from appendectomy than are non-HIV patients according to an analysis of cases in a national surgical database presented at the Association for Academic Surgery/Society of University Surgeons Academic Surgical Congress.

Dr. Michael C. Smith of the State University of New York, Brooklyn, explained why he and his colleagues felt it was time to update the literature on HIV and surgery. “Much of the literature on appendectomy in the setting of HIV is either from the early 1990s or elsewhere in the world, and it shows greatly increased complication rates in these patients,” he said.

Dr. Michael C. Smith

Dr. Michael C. Smith

The analysis queried the Nationwide Inpatient Sample (NIS) database for all patients who had acute appendicitis and appendectomy during 2005-2012. The analysis included patients who had both open and laparoscopic appendectomy, and compared the HIV group that did not have AIDS with the non-HIV group, Dr. Smith said. The population with AIDS, along with patients who had interval appendectomies after appendicitis, were excluded.

The study looked at 821 patients with HIV and 338,425 patients without HIV as controls.

“The only significant difference we found between the two groups was hospital length of stay, which differed by about three-quarters of a day,” Dr. Smith said. Patients with HIV spent on average 3.8 days in the hospital after appendectomy vs. 3 days for non-HIV patients. “Other complication rates were nonsignificant by our study,” he said.

The average total charge for HIV patients was also higher, $33,350 vs. $30,714, the analysis showed.

Dr. Smith acknowledged some limitations in using the NIS database, most notably that the data were from index hospitalizations only. “So we probably did not capture people who returned to the hospital on postoperative day 3, 4, and 5 after they were discharged home,” he said. “Therefore, prospective studies are needed to validate these results.”

He also said that the study did not differentiate between operations for perforated and nonperforated appendix, and he and his coresearchers could not determine why the HIV population had longer hospital stays.

Dr. Smith and coauthors had no financial relationships to disclose.

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