Gahagan John V, Halabi Wissam J, Nguyen Vinh Q, Carmichael Joseph C, Pigazzi Alessio, Stamos Michael J, Mills Steven D
Department of Surgery, Irvine School of Medicine, University of California, Irvine, CA, USA.
Department of Statistics, University of California Irvine, Irvine, CA, USA.
J Gastrointest Surg. 2016 Jun;20(6):1239-46. doi: 10.1007/s11605-016-3119-x. Epub 2016 Mar 3.
HIV has become a chronic disease, which may render this population more prone to developing the colorectal pathologies that typically affect older Americans.
A retrospective review of the Nationwide Inpatient Sample was performed to identify patients who underwent colon and rectal surgery from 2001 to 2010. Multivariate analysis was used to evaluate outcomes among the general population, patients with HIV, and patients with AIDS.
Hospital admissions for colon and rectal procedures of patients with HIV/AIDS grew at a faster rate than all-cause admissions of patients with HIV/AIDS, with mean yearly increases of 17.8 and 2.1 %, respectively (p < 0.05). Patients with HIV/AIDS undergoing colon and rectal operations for cancer, polyps, diverticular disease, and Clostridium difficile were younger than the general population (51 vs. 65 years; p < 0.01). AIDS was independently associated with increased odds of mortality (OR 2.11; 95 % CI 1.24, 3.61), wound complications (OR 1.53; 95 % CI 1.09, 2.17), and pneumonia (OR 2.02; 95 % CI 1.33, 3.08). Risk-adjusted outcomes of colorectal surgery in patients with HIV did not differ significantly from the general population.
Postoperative outcomes in patients with HIV are similar to the general population, while patients with AIDS have a higher risk of mortality and certain complications.
艾滋病病毒已成为一种慢性病，这可能使该人群更容易患上通常影响美国老年人的结直肠疾病。
对全国住院患者样本进行回顾性研究，以确定2001年至2010年期间接受结肠和直肠手术的患者。采用多变量分析评估普通人群、艾滋病病毒感染者和艾滋病患者的手术结果。
艾滋病病毒/艾滋病患者的结肠和直肠手术住院人数增长速度快于艾滋病病毒/艾滋病患者的全因住院人数，年平均增长率分别为17.8%和2.1%（p<0.05）。因癌症、息肉、憩室病和艰难梭菌接受结肠和直肠手术的艾滋病病毒/艾滋病患者比普通人群年轻（51岁对65岁；p<0.01）。艾滋病独立与死亡几率增加（比值比2.11；95%置信区间1.24，3.61）、伤口并发症（比值比1.53；95%置信区间1.09，2.17）和肺炎（比值比2.02；95%置信区间1.33，3.08）相关。艾滋病病毒感染者结直肠手术的风险调整后结果与普通人群无显著差异。
艾滋病病毒感染者的术后结果与普通人群相似，而艾滋病患者的死亡风险和某些并发症风险较高。
