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World J Surg ; 42(8): 2412-2420, 2018 08.
Artículo en Inglés | MEDLINE | ID: mdl-29387958

RESUMEN

BACKGROUND: The purpose of this study was to determine whether the outcomes of hemodynamically stable patients undergoing exploratory laparotomy for penetrating abdominal trauma differed as a result of their HIV status. METHODS: This was an observational, prospective study from February 2016 to May 2017. All hemodynamically stable patients with penetrating abdominal trauma requiring a laparotomy were included. The mechanism of injury, the HIV status, age, the penetrating abdominal trauma index (PATI), and the revised trauma score (RTS) were entered into a binary logistic regression model. Outcome parameters were in-hospital death, morbidity, admission to intensive care unit (ICU), relaparotomy within 30 days, and length of stay longer than 30 days. RESULTS: A total of 209 patients, 94% male, with a mean age of 29 ± 10 years were analysed. Twenty-eight patients (13%) were HIV positive. The two groups were comparable. Ten (4.8%) laparotomies were negative. There were two (0.96%) deaths, both in the HIV negative group. The complication rate was 34% (n = 72). Twenty-nine patients (14%) were admitted to the ICU. A higher PATI, older age, and a lower RTS were significant risk factors for ICU admission. After 30 days, 12 patients (5.7%) were still in hospital. Twenty-four patients (11%) underwent a second laparotomy. The PATI score was the single independent predictor for complications, relaparotomy, and hospital stay longer than 30 days. CONCLUSIONS: Preliminary results reveal that HIV status does not influence outcomes in patients with penetrating abdominal trauma.


Asunto(s)
Traumatismos Abdominales/cirugía , Seronegatividad para VIH , Seropositividad para VIH/complicaciones , Heridas Penetrantes/cirugía , Traumatismos Abdominales/complicaciones , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Adulto , Recuento de Linfocito CD4 , Femenino , Humanos , Laparotomía/efectos adversos , Tiempo de Internación , Modelos Logísticos , Masculino , Complicaciones Posoperatorias , Estudios Prospectivos , Resultado del Tratamiento , Heridas Penetrantes/complicaciones
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