Human Immunodeficiency Virus Infection in Trauma Patients: Where Do We Stand?
OBJECTIVE:The human immunodeficiency virus (HIV) epidemic is a growing health care problem. The purpose of this study was to examine the relationship between HIV infection and trauma patient treatment, complications, and mortality. METHODS:The Pennsylvania Trauma Outcome Study database was used to i...
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| Veröffentlicht in: | The Journal of trauma, injury, infection, and critical care injury, infection, and critical care, 2005-01, Vol.58 (1), p.88-93 |
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| container_title | The Journal of trauma, injury, infection, and critical care |
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| creator | Stawicki, Stanislaw P. Hoff, William S. Hoey, Brian A. Grossman, Michael D. Scoll, Benjamin Reed, James F. |
| description | OBJECTIVE:The human immunodeficiency virus (HIV) epidemic is a growing health care problem. The purpose of this study was to examine the relationship between HIV infection and trauma patient treatment, complications, and mortality.
METHODS:The Pennsylvania Trauma Outcome Study database was used to identify trauma patients with known HIV-positive status (HP) and randomly selected age-matched controls (CL). Demographics, Injury Severity Score, Glasgow Coma Scale score, mechanism of injury, preexisting conditions, complications, mortality, hospital length of stay (HLOS), intensive care unit length of stay (ILOS), and operative interventions were compared.
RESULTS:Demographics, vital signs on presentation, and Injury Severity Score were similar between the HP and CL groups. There was no difference in mortality between the two groups (3.6% vs. 3.1%, p = 0.6447). HP patients were more likely to present with penetrating injuries (22.6% vs. 15.8%, p < 0.0031) and had significantly fewer major orthopedic injuries than CL patients (p < 0.01). HP patients were more likely to have a history of a neurologic condition; chronic drug/alcohol use; psychiatric diagnosis; or liver, pulmonary, and/or renal disease (all p < 0.01). HP patients had more pulmonary complications (12.3% vs. 4.1%), renal complications, and infectious/septic complications (all p < 0.01) than controls. Infection/sepsis and pulmonary complications were associated with significant mortality in HP patients. HP patients underwent more thoracostomies (7.5% vs. 4.4%, p = 0.0235) and exploratory laparotomies (7.0% vs. 2.4%, p = 0.0002). HLOS (10.2 ± 10 vs. 6.8 ± 8.6 days, p = 0.001) and ILOS (2.3 ± 7.2 vs. 1.5 ± 4.9 days, p = 0.0178) were greater for HP patients. HP patients were less likely than controls to be discharged directly to home (67.8% vs. 82.7%, p = 0.0001).
CONCLUSION:HP patients had more preexisting conditions and complications than controls. There was no difference in overall mortality between the two groups. However, pulmonary/infectious complications were associated with significant mortality in HP patients. HP patients consumed more health care resources than controls, as exemplified by greater ILOS and HLOS and more operative procedures. |
| doi_str_mv | 10.1097/01.TA.0000124279.08072.F5 |
| format | Article |
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METHODS:The Pennsylvania Trauma Outcome Study database was used to identify trauma patients with known HIV-positive status (HP) and randomly selected age-matched controls (CL). Demographics, Injury Severity Score, Glasgow Coma Scale score, mechanism of injury, preexisting conditions, complications, mortality, hospital length of stay (HLOS), intensive care unit length of stay (ILOS), and operative interventions were compared.
RESULTS:Demographics, vital signs on presentation, and Injury Severity Score were similar between the HP and CL groups. There was no difference in mortality between the two groups (3.6% vs. 3.1%, p = 0.6447). HP patients were more likely to present with penetrating injuries (22.6% vs. 15.8%, p < 0.0031) and had significantly fewer major orthopedic injuries than CL patients (p < 0.01). HP patients were more likely to have a history of a neurologic condition; chronic drug/alcohol use; psychiatric diagnosis; or liver, pulmonary, and/or renal disease (all p < 0.01). HP patients had more pulmonary complications (12.3% vs. 4.1%), renal complications, and infectious/septic complications (all p < 0.01) than controls. Infection/sepsis and pulmonary complications were associated with significant mortality in HP patients. HP patients underwent more thoracostomies (7.5% vs. 4.4%, p = 0.0235) and exploratory laparotomies (7.0% vs. 2.4%, p = 0.0002). HLOS (10.2 ± 10 vs. 6.8 ± 8.6 days, p = 0.001) and ILOS (2.3 ± 7.2 vs. 1.5 ± 4.9 days, p = 0.0178) were greater for HP patients. HP patients were less likely than controls to be discharged directly to home (67.8% vs. 82.7%, p = 0.0001).
CONCLUSION:HP patients had more preexisting conditions and complications than controls. There was no difference in overall mortality between the two groups. However, pulmonary/infectious complications were associated with significant mortality in HP patients. HP patients consumed more health care resources than controls, as exemplified by greater ILOS and HLOS and more operative procedures.</description><identifier>ISSN: 0022-5282</identifier><identifier>EISSN: 1529-8809</identifier><identifier>DOI: 10.1097/01.TA.0000124279.08072.F5</identifier><identifier>PMID: 15674156</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Adolescent ; Adult ; Aged ; Alcoholism and acute alcohol poisoning ; Biological and medical sciences ; Case-Control Studies ; Cause of Death ; Chi-Square Distribution ; Comorbidity ; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes ; Female ; Glasgow Coma Scale ; HIV Infections - complications ; HIV Infections - epidemiology ; Hospital Mortality ; Human viral diseases ; Humans ; Infectious diseases ; Injury Severity Score ; Intensive Care Units - statistics & numerical data ; Length of Stay - statistics & numerical data ; Male ; Medical sciences ; Middle Aged ; Nervous system (semeiology, syndromes) ; Neurology ; Pennsylvania - epidemiology ; Prevalence ; Registries ; Toxicology ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Wounds and Injuries - complications ; Wounds and Injuries - epidemiology</subject><ispartof>The Journal of trauma, injury, infection, and critical care, 2005-01, Vol.58 (1), p.88-93</ispartof><rights>2005 Lippincott Williams & Wilkins, Inc.</rights><rights>2005 INIST-CNRS</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3905-d3d1b63a608da88faf950de5a957328d9fafa548f7189de3de479485c7dc94703</citedby><cites>FETCH-LOGICAL-c3905-d3d1b63a608da88faf950de5a957328d9fafa548f7189de3de479485c7dc94703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16460231$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15674156$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stawicki, Stanislaw P.</creatorcontrib><creatorcontrib>Hoff, William S.</creatorcontrib><creatorcontrib>Hoey, Brian A.</creatorcontrib><creatorcontrib>Grossman, Michael D.</creatorcontrib><creatorcontrib>Scoll, Benjamin</creatorcontrib><creatorcontrib>Reed, James F.</creatorcontrib><title>Human Immunodeficiency Virus Infection in Trauma Patients: Where Do We Stand?</title><title>The Journal of trauma, injury, infection, and critical care</title><addtitle>J Trauma</addtitle><description>OBJECTIVE:The human immunodeficiency virus (HIV) epidemic is a growing health care problem. The purpose of this study was to examine the relationship between HIV infection and trauma patient treatment, complications, and mortality.
METHODS:The Pennsylvania Trauma Outcome Study database was used to identify trauma patients with known HIV-positive status (HP) and randomly selected age-matched controls (CL). Demographics, Injury Severity Score, Glasgow Coma Scale score, mechanism of injury, preexisting conditions, complications, mortality, hospital length of stay (HLOS), intensive care unit length of stay (ILOS), and operative interventions were compared.
RESULTS:Demographics, vital signs on presentation, and Injury Severity Score were similar between the HP and CL groups. There was no difference in mortality between the two groups (3.6% vs. 3.1%, p = 0.6447). HP patients were more likely to present with penetrating injuries (22.6% vs. 15.8%, p < 0.0031) and had significantly fewer major orthopedic injuries than CL patients (p < 0.01). HP patients were more likely to have a history of a neurologic condition; chronic drug/alcohol use; psychiatric diagnosis; or liver, pulmonary, and/or renal disease (all p < 0.01). HP patients had more pulmonary complications (12.3% vs. 4.1%), renal complications, and infectious/septic complications (all p < 0.01) than controls. Infection/sepsis and pulmonary complications were associated with significant mortality in HP patients. HP patients underwent more thoracostomies (7.5% vs. 4.4%, p = 0.0235) and exploratory laparotomies (7.0% vs. 2.4%, p = 0.0002). HLOS (10.2 ± 10 vs. 6.8 ± 8.6 days, p = 0.001) and ILOS (2.3 ± 7.2 vs. 1.5 ± 4.9 days, p = 0.0178) were greater for HP patients. HP patients were less likely than controls to be discharged directly to home (67.8% vs. 82.7%, p = 0.0001).
CONCLUSION:HP patients had more preexisting conditions and complications than controls. There was no difference in overall mortality between the two groups. However, pulmonary/infectious complications were associated with significant mortality in HP patients. HP patients consumed more health care resources than controls, as exemplified by greater ILOS and HLOS and more operative procedures.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Alcoholism and acute alcohol poisoning</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>Cause of Death</subject><subject>Chi-Square Distribution</subject><subject>Comorbidity</subject><subject>Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes</subject><subject>Female</subject><subject>Glasgow Coma Scale</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - epidemiology</subject><subject>Hospital Mortality</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Injury Severity Score</subject><subject>Intensive Care Units - statistics & numerical data</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system (semeiology, syndromes)</subject><subject>Neurology</subject><subject>Pennsylvania - epidemiology</subject><subject>Prevalence</subject><subject>Registries</subject><subject>Toxicology</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Wounds and Injuries - complications</subject><subject>Wounds and Injuries - epidemiology</subject><issn>0022-5282</issn><issn>1529-8809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkNtq3DAQhkVpaLZpXqGoF-2dHR0tqTdlSbvNQkoL2SSXQpHGrFtbTiSbkLevNruwMzDDDN8c-BH6RElNiVEXhNabZU2KUSaYMjXRRLF6Jd-gBZXMVFoT8xYtCGGskkyzU_Q-57-FF4Lrd-iUykaJEhbo19U8uIjXwzDHMUDb-Q6if8F3XZozXscW_NSNEXcRb5IrLP7jpoJM-Su-30IC_H3E94BvJhfDtw_opHV9hvNDPkO3qx-by6vq-vfP9eXyuvLcEFkFHuhDw11DdHBat641kgSQzkjFmQ6mdJwUulVUmwA8gFBGaOlV8EYows_Ql_3exzQ-zZAnO3TZQ9-7COOcbaN4cbkDzR70acw5QWsfUze49GIpsTstLaF2s7RHLe2rlnYly-zHw5H5YYBwnDyIV4DPB8Bl7_o2uei7fOQa0RDGaeHEnnse-wlS_tfPz5DsFlw_bV9Py_JuxUomtFTV7hnJ_wO-bItl</recordid><startdate>200501</startdate><enddate>200501</enddate><creator>Stawicki, Stanislaw P.</creator><creator>Hoff, William S.</creator><creator>Hoey, Brian A.</creator><creator>Grossman, Michael D.</creator><creator>Scoll, Benjamin</creator><creator>Reed, James F.</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200501</creationdate><title>Human Immunodeficiency Virus Infection in Trauma Patients: Where Do We Stand?</title><author>Stawicki, Stanislaw P. ; Hoff, William S. ; Hoey, Brian A. ; Grossman, Michael D. ; Scoll, Benjamin ; Reed, James F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3905-d3d1b63a608da88faf950de5a957328d9fafa548f7189de3de479485c7dc94703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Alcoholism and acute alcohol poisoning</topic><topic>Biological and medical sciences</topic><topic>Case-Control Studies</topic><topic>Cause of Death</topic><topic>Chi-Square Distribution</topic><topic>Comorbidity</topic><topic>Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes</topic><topic>Female</topic><topic>Glasgow Coma Scale</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - epidemiology</topic><topic>Hospital Mortality</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Injury Severity Score</topic><topic>Intensive Care Units - statistics & numerical data</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system (semeiology, syndromes)</topic><topic>Neurology</topic><topic>Pennsylvania - epidemiology</topic><topic>Prevalence</topic><topic>Registries</topic><topic>Toxicology</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Wounds and Injuries - complications</topic><topic>Wounds and Injuries - epidemiology</topic><toplevel>online_resources</toplevel><creatorcontrib>Stawicki, Stanislaw P.</creatorcontrib><creatorcontrib>Hoff, William S.</creatorcontrib><creatorcontrib>Hoey, Brian A.</creatorcontrib><creatorcontrib>Grossman, Michael D.</creatorcontrib><creatorcontrib>Scoll, Benjamin</creatorcontrib><creatorcontrib>Reed, James F.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of trauma, injury, infection, and critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stawicki, Stanislaw P.</au><au>Hoff, William S.</au><au>Hoey, Brian A.</au><au>Grossman, Michael D.</au><au>Scoll, Benjamin</au><au>Reed, James F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Human Immunodeficiency Virus Infection in Trauma Patients: Where Do We Stand?</atitle><jtitle>The Journal of trauma, injury, infection, and critical care</jtitle><addtitle>J Trauma</addtitle><date>2005-01</date><risdate>2005</risdate><volume>58</volume><issue>1</issue><spage>88</spage><epage>93</epage><pages>88-93</pages><issn>0022-5282</issn><eissn>1529-8809</eissn><abstract>OBJECTIVE:The human immunodeficiency virus (HIV) epidemic is a growing health care problem. The purpose of this study was to examine the relationship between HIV infection and trauma patient treatment, complications, and mortality.
METHODS:The Pennsylvania Trauma Outcome Study database was used to identify trauma patients with known HIV-positive status (HP) and randomly selected age-matched controls (CL). Demographics, Injury Severity Score, Glasgow Coma Scale score, mechanism of injury, preexisting conditions, complications, mortality, hospital length of stay (HLOS), intensive care unit length of stay (ILOS), and operative interventions were compared.
RESULTS:Demographics, vital signs on presentation, and Injury Severity Score were similar between the HP and CL groups. There was no difference in mortality between the two groups (3.6% vs. 3.1%, p = 0.6447). HP patients were more likely to present with penetrating injuries (22.6% vs. 15.8%, p < 0.0031) and had significantly fewer major orthopedic injuries than CL patients (p < 0.01). HP patients were more likely to have a history of a neurologic condition; chronic drug/alcohol use; psychiatric diagnosis; or liver, pulmonary, and/or renal disease (all p < 0.01). HP patients had more pulmonary complications (12.3% vs. 4.1%), renal complications, and infectious/septic complications (all p < 0.01) than controls. Infection/sepsis and pulmonary complications were associated with significant mortality in HP patients. HP patients underwent more thoracostomies (7.5% vs. 4.4%, p = 0.0235) and exploratory laparotomies (7.0% vs. 2.4%, p = 0.0002). HLOS (10.2 ± 10 vs. 6.8 ± 8.6 days, p = 0.001) and ILOS (2.3 ± 7.2 vs. 1.5 ± 4.9 days, p = 0.0178) were greater for HP patients. HP patients were less likely than controls to be discharged directly to home (67.8% vs. 82.7%, p = 0.0001).
CONCLUSION:HP patients had more preexisting conditions and complications than controls. There was no difference in overall mortality between the two groups. However, pulmonary/infectious complications were associated with significant mortality in HP patients. HP patients consumed more health care resources than controls, as exemplified by greater ILOS and HLOS and more operative procedures.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>15674156</pmid><doi>10.1097/01.TA.0000124279.08072.F5</doi><tpages>6</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Alcoholism and acute alcohol poisoning Biological and medical sciences Case-Control Studies Cause of Death Chi-Square Distribution Comorbidity Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes Female Glasgow Coma Scale HIV Infections - complications HIV Infections - epidemiology Hospital Mortality Human viral diseases Humans Infectious diseases Injury Severity Score Intensive Care Units - statistics & numerical data Length of Stay - statistics & numerical data Male Medical sciences Middle Aged Nervous system (semeiology, syndromes) Neurology Pennsylvania - epidemiology Prevalence Registries Toxicology Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Wounds and Injuries - complications Wounds and Injuries - epidemiology |
| title | Human Immunodeficiency Virus Infection in Trauma Patients: Where Do We Stand? |
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