P21. Inpatient outcomes after elective lumbar spinal fusion for patients with human immunodeficiency virus in the absence of acquired immunodeficiency syndrome

Abstract

BACKGROUND CONTEXT To our knowledge, no prior study has evaluated outcomes after elective lumbar spinal surgery in human immunodeficiency virus (HIV) patients without acquired immunodeficiency syndrome (AIDS). PURPOSE This review investigated the impact of HIV-positive status (without AIDS) on outcomes after elective lumbar fusion for degenerative disc disease (DDD). STUDY DESIGN/SETTING Adult patients registered in the Nationwide Inpatient Sample (2002-2011) undergoing elective lumbar fusion for DDD were extracted. PATIENT SAMPLE The patient sample included 612,000 individual patient hospitalizations (0.07% were HIV positive) of lumbar fusion for DDD. OUTCOME MEASURES The following outcome measures were recorded: wound complications, infection rate, cardiac, respiratory, neurologic, gastrointestinal complications, thromboembolic events and death. METHODS This cohort included 612,000 hospitalizations (0.07% were HIV positive) of lumbar fusion for DDD. HIV-positive patients were compared with HIV-negative patients undergoing lumbar fusion surgery and complications/adverse outcomes were recorded. RESULTS This cohort included 612,000 hospitalizations (0.07% were HIV positive) of lumbar fusion for DDD. Compared with HIV-negative patients undergoing lumbar fusion, HIV-positive patients were younger (47 vs 55 years), male (61% vs 42%), largely insured by Medicare (30% vs 5%), and had higher rates of chronic obstructive pulmonary disease (23.7% vs 14.6%) (all P CONCLUSIONS Even in this selected cohort of well-controlled HIV patients, there were high complications, with concerning rates of death and respiratory complications. These data shed new light on elective spine surgery in HIV patients and may influence the treatment algorithm of surgeons who are familiar with older studies. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.