Study of morbidity and mortality in HIV positive surgical patients in Western Rajasthan

Abstract

Background: HIV infection affects the differential diagnosis of surgical disease nutritional status and life expectancy. Some have suggested that HIV infection may also influence post-operative wound healing and complication rates. Others have stated that HIV infection should have only minor influence on decision-making for many surgical conditions and therefore standard surgical approaches are appropriate. Methods: All HIV positive patients admitted in general surgical wards were divided into two groups- 1. Conservative, 2. Operative. Operative patients were placed into 4 subgroups according to CDC surgical wound classification-Clean, clean-contaminated, contaminated and dirty-infected. Patients were followed up in post-operative ward till discharge or mortality. At the time of discharge outcome were rated as-Good, fair and poor.Results: Patients between age 31-30 and 41-50 years were commonly and equally affected (60.6%). Farmer males were predominantly involved in all age groups except of age group >50 years. 28 (84.85%) patients were on ART therapy. Most common affected body part is abdomen (60.60%). In 22 (66.67%) cases operative procedure done; among them 14 (63.63%) were emergency and 8 (36.37%) were elective. Fistulectomy (25%) was commonest in elective surgeries and open appendicectomy (35.71%) was commonest in emergency surgeries. In 4 cases systemic complications occurred and one case had local complication. 30 patients were discharged in satisfactory condition and 3 patients expired.Conclusions: No significant correlation between survival outcomes (mortality and morbidity) with hospital stay (p=0.444), between type of operation (emergency or elective) and mortality (p=0.502) and demographic and clinical variables (age, gender, hospital stay, effective antiretroviral therapy (ART) duration) to survival outcome of HIV patients.