Laboratory parameters as predictors of operative outcome after major abdominal surgery in AIDS- and HIV-infected patients.

Surgeons throughout the country are frequently asked to consult on acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV)-infected patients experiencing abdominal pain. Disease processes vary remarkably within this population and often occur with confusing presentations and unusual pathologies related to the immunocompromised state. With the increased awareness and treatment of HIV infection, it can be anticipated that many patients will require surgery for secondary complications of AIDS, in addition to surgical problems unrelated to HIV infection. Twenty-five patients diagnosed with HIV infection underwent major abdominal surgery between 1986 and 1990 at The Mount Sinai Medical Center. Those patients classified as having AIDS had a longer post procedure hospitalization (19 days vs 9 days; P < 0.05) and a higher mortality rate (33% vs 10%). All of the patients who underwent appendectomy survived with few complications. Excluding appendectomy patients, operative mortality was predicted by low serum albumin (P < 0.001). In addition, preoperative hematocrits were considerably lower in non-survivors. Total serum protein and total WBC counts were not predictors of operative outcome.