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

Amber Chi, Bryan E. Adams, Joanna Sesti, Subroto Paul, Amber L. Turner, David August, Darren Carpizo, Timothy Kennedy, Miral Grandhi, H. Richard Alexander, Steven K. Libutti, Stuart Geffner, Russell C. Langan

Research output: Contribution to journalArticle

Abstract

Introduction: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)3019-3026
Number of pages8
JournalWorld Journal of Surgery
Volume43
Issue number12
DOIs
StatePublished - Dec 1 2019

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HIV
Population
Neoplasms
Length of Stay
Logistic Models
Lung
Colectomy
Quality of Health Care
International Classification of Diseases
Insurance
Inpatients
Viruses
Safety

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Chi, Amber ; Adams, Bryan E. ; Sesti, Joanna ; Paul, Subroto ; Turner, Amber L. ; August, David ; Carpizo, Darren ; Kennedy, Timothy ; Grandhi, Miral ; Alexander, H. Richard ; Libutti, Steven K. ; Geffner, Stuart ; Langan, Russell C. / Outcomes Following Major Oncologic Operations for Non-AIDS-Defining Cancers in the HIV Population : A Matched Comparison to the General Population. In: World Journal of Surgery. 2019 ; Vol. 43, No. 12. pp. 3019-3026.
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abstract = "Introduction: 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. Methods: 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. Results: 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. Conclusions: 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.",
author = "Amber Chi and Adams, {Bryan E.} and Joanna Sesti and Subroto Paul and Turner, {Amber L.} and David August and Darren Carpizo and Timothy Kennedy and Miral Grandhi and Alexander, {H. Richard} and Libutti, {Steven K.} and Stuart Geffner and Langan, {Russell C.}",
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Outcomes Following Major Oncologic Operations for Non-AIDS-Defining Cancers in the HIV Population : A Matched Comparison to the General Population. / Chi, Amber; Adams, Bryan E.; Sesti, Joanna; Paul, Subroto; Turner, Amber L.; August, David; Carpizo, Darren; Kennedy, Timothy; Grandhi, Miral; Alexander, H. Richard; Libutti, Steven K.; Geffner, Stuart; Langan, Russell C.

In: World Journal of Surgery, Vol. 43, No. 12, 01.12.2019, p. 3019-3026.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Outcomes Following Major Oncologic Operations for Non-AIDS-Defining Cancers in the HIV Population

T2 - A Matched Comparison to the General Population

AU - Chi, Amber

AU - Adams, Bryan E.

AU - Sesti, Joanna

AU - Paul, Subroto

AU - Turner, Amber L.

AU - August, David

AU - Carpizo, Darren

AU - Kennedy, Timothy

AU - Grandhi, Miral

AU - Alexander, H. Richard

AU - Libutti, Steven K.

AU - Geffner, Stuart

AU - Langan, Russell C.

PY - 2019/12/1

Y1 - 2019/12/1

N2 - Introduction: 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. Methods: 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. Results: 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. Conclusions: 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.

AB - Introduction: 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. Methods: 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. Results: 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. Conclusions: 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.

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