Outcomes Following Major Oncologic Operations for Non-AIDS-Defining Cancers in the HIV Population: A Matched Comparison to the General Population.


Journal

World journal of surgery
ISSN: 1432-2323
Titre abrégé: World J Surg
Pays: United States
ID NLM: 7704052

Informations de publication

Date de publication:
12 2019
Historique:
pubmed: 8 9 2019
medline: 28 7 2020
entrez: 8 9 2019
Statut: ppublish

Résumé

Human immunodeficiency virus (HIV) patients are living longer due to the availability of antiretroviral therapies, and non-AIDS-defining cancers are becoming more prevalent in this patient population. A paucity of data remains on post-operative outcomes following resection of non-AIDS-defining cancers in the HIV population. The National Inpatient Sample was utilized to identify patients who underwent surgical resection for malignancy from 2005 to 2015 (HIV, N = 52,742; non-HIV, N = 11,885,184). Complications were categorized by international classification of disease (ICD)-9 diagnosis codes. Cohorts were matched on insurance, household income, zip code and urban/rural setting. Logistic regression assessed whether HIV was an independent predictor of post-operative complications. Descriptive statistics found HIV patients to have an increased rate of complications following select oncologic surgical resections. Univariate and multivariate logistic regression found HIV to only be an independent predictor of complications following pulmonary lobectomy (p = 0.011; OR 2.93, 95% CI 1.29-6.73). Length of stay was statistically longer following colectomy (2.61 days, 95% CI 1.98-3.44) in those with HIV. Our findings are hypothesis generating and highlight the potential safety of major cancer surgery in the HIV population. However, care providers need be cognizant of the potential increased risk of post-operative complications following pulmonary lobectomy and the potential for increased length of stay. These findings are an initial insight into quality of care and outcomes metrics on HIV patients undergoing major cancer operations.

Identifiants

pubmed: 31493193
doi: 10.1007/s00268-019-05151-3
pii: 10.1007/s00268-019-05151-3
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3019-3026

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Auteurs

Amber Chi (A)

Department of Surgery, Saint Barnabas Medical Center, RWJBarnabas Health, Livingston, NJ, USA.

Bryan E Adams (BE)

Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA.

Joanna Sesti (J)

Department of Surgery, Saint Barnabas Medical Center, RWJBarnabas Health, Livingston, NJ, USA.

Subroto Paul (S)

Department of Surgery, Saint Barnabas Medical Center, RWJBarnabas Health, Livingston, NJ, USA.

Amber L Turner (AL)

Department of Surgery, Saint Barnabas Medical Center, RWJBarnabas Health, Livingston, NJ, USA.

David August (D)

Department of Surgery, Saint Barnabas Medical Center, RWJBarnabas Health, Livingston, NJ, USA.
Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.

Darren Carpizo (D)

Department of Surgery, Saint Barnabas Medical Center, RWJBarnabas Health, Livingston, NJ, USA.
Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.

Timothy Kennedy (T)

Department of Surgery, Saint Barnabas Medical Center, RWJBarnabas Health, Livingston, NJ, USA.
Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.

Miral Grandhi (M)

Department of Surgery, Saint Barnabas Medical Center, RWJBarnabas Health, Livingston, NJ, USA.
Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.

H Richard Alexander (HR)

Department of Surgery, Saint Barnabas Medical Center, RWJBarnabas Health, Livingston, NJ, USA.
Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.

Steven K Libutti (SK)

Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.

Stuart Geffner (S)

Department of Surgery, Saint Barnabas Medical Center, RWJBarnabas Health, Livingston, NJ, USA.

Russell C Langan (RC)

Department of Surgery, Saint Barnabas Medical Center, RWJBarnabas Health, Livingston, NJ, USA. russell.langan@rwjbh.org.
Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA. russell.langan@rwjbh.org.

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