Department of Surgery, St Paul's Hospital & Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Ann Surg. 2012 Jul;256(1):170-6. doi: 10.1097/SLA.0b013e318255896b.
Factors that predict HIV (human immunodeficiency virus)/AIDS patient postoperative mortality have remained poorly defined.
The primary objective of this study was to identify factors predictive of short-term, postoperative mortality in HIV/AIDS patients. The secondary objective of this study was to develop a scoring system that would predict short-term postoperative mortality in HIV/AIDS patients.
We retrospectively reviewed all HIV/AIDS patients who underwent surgical procedures in British Columbia, Canada, between April 1995 and March 2002. The primary outcome evaluated was 30-day postoperative mortality. Demographic, clinical, and hospitalization-related data were obtained and utilized to predict outcomes using a logistic regression model.
A total of 2305 procedures were carried out on 1322 patients during the study period. Admissions were classified as urgent/emergent for 1311 procedures (57%) and the overall 30-day postoperative mortality was 9.5% (126 deaths). Urgent/emergent admission, older age, prior surgery, a CD4 cell count of ≤ 50 cells/mm, a hemoglobin level ≤ 120 g/L, and a white blood cell count >11 g/L within 90 days before the surgical procedure was predictive of an increased 30-day postoperative mortality in a multivariate model. Using these variables, we formulated the HIV Surgical Mortality Score (HSMS) to obtain the median-estimated probability of postoperative death.
For accurate preoperative mortality risk stratification for HIV/AIDS patients, we have found that several clinical and laboratory variables must be evaluated. If appropriately validated, our proposed HSMS could be utilized to estimate the probability of short-term postoperative death among HIV/AIDS patients.
预测 HIV（人类免疫缺陷病毒）/艾滋病患者术后死亡率的因素仍未得到明确界定。
本研究的主要目的是确定预测 HIV/AIDS 患者短期术后死亡率的因素。本研究的次要目的是开发一种评分系统，以预测 HIV/AIDS 患者的短期术后死亡率。
我们回顾性分析了 1995 年 4 月至 2002 年 3 月期间在加拿大不列颠哥伦比亚省接受手术的所有 HIV/AIDS 患者。评估的主要结果是 30 天术后死亡率。收集了人口统计学、临床和住院相关数据，并使用逻辑回归模型来预测结果。
在研究期间，共有 2305 例手术在 1322 名患者中进行。入院被分为紧急/紧急情况 1311 例（57%），总体 30 天术后死亡率为 9.5%（126 例死亡）。紧急/紧急入院、年龄较大、既往手术、CD4 细胞计数≤50 个/毫米、血红蛋白水平≤120g/L、手术前 90 天内白细胞计数>11g/L，在多变量模型中预测 30 天术后死亡率增加。使用这些变量，我们制定了 HIV 手术死亡率评分（HSMS）以获得术后死亡的中位数估计概率。
为了对 HIV/AIDS 患者进行准确的术前死亡率风险分层，我们发现必须评估几个临床和实验室变量。如果得到适当验证，我们提出的 HSMS 可用于估计 HIV/AIDS 患者短期术后死亡的概率。
