Turk J Med Sci. 2018 Feb 23;48(1):46-51. doi: 10.3906/sag-1507-120.
Background/aim: The relevance of HIV infection in perioperative renal risk stratification remains unclear. This research sought to investigate the impact of HIV infection, as well as other established preoperative risk factors for poor perioperative renal outcome (PPRO), in a population of 565,225 adult noncardiac surgery patients whose data were obtained from the 2009-2011 California State Inpatient Database. Materials and methods: HIV status, established preoperative risk factors, and the study outcome (PPRO) were determined with the Clinical Classification Software codes recorded for each patient. Data were analyzed using univariate (Mann-Whitney U test, chi-square, and Fisher′s exact test) and multivariate (binary logistic regression) statistical methods. Results: The established preoperative risk factors were independently associated with PPRO. HIV infection was not an independent risk factor for PPRO in this study (odds ratio: 1.573, 95% confidence interval: 0.998-2.480; P = 0.051). Patients with HIV infection tended to have a higher burden of certain established preoperative risk factors for PPRO than patients without HIV infection. Conclusion: HIV-infected patients should be thoroughly screened for established preoperative risk factors and carefully managed during the perioperative period to reduce their risk of PPRO.
背景/目的:HIV 感染与围手术期肾脏风险分层的相关性仍不清楚。本研究旨在调查 565225 名成年非心脏手术患者的 HIV 感染以及其他既定围手术期肾脏不良结局(PPRO)的术前危险因素对其的影响,这些患者的数据来自 2009-2011 年加利福尼亚州住院患者数据库。
采用临床分类软件(Clinical Classification Software)为每位患者记录的代码来确定 HIV 状态、既定术前危险因素和研究结局(PPRO)。采用单变量(Mann-Whitney U 检验、卡方检验和 Fisher′s 确切检验)和多变量(二项逻辑回归)统计方法进行数据分析。
既定的术前危险因素与 PPRO 独立相关。在本研究中,HIV 感染不是 PPRO 的独立危险因素(比值比:1.573,95%置信区间:0.998-2.480;P=0.051)。与未感染 HIV 的患者相比,感染 HIV 的患者往往具有更高的 PPRO 既定术前危险因素负担。
HIV 感染患者应彻底筛查既定的术前危险因素,并在围手术期进行精心管理,以降低其 PPRO 风险。