Management of Acute Appendicitis in HIV/AIDs Patients: A 19-year Review from the National In-Patient Sample.

ABSTRACT

BACKGROUND: Acute Appendicitis (AA), one of the most common surgical emergencies, is usually managed operatively. There is a paucity of data addressing how HIV/AIDS affects management of acute uncomplicated appendicitis. METHODS: A retrospective review of HIV/AIDS positive (HPos) versus negative (HNeg) patients with acute, uncomplicated appendicitis over a 19-year period. The primary outcome was undergoing appendectomy. RESULTS: Among 912,779 AA patients, 4,291 patients were HPos. HIV rates increased from 3.8/1,000 in 2000 to 6.3 per 1,000 appendicitis cases in 2019 (p<0.001). HPos patients were older, less likely to have private insurance, and more likely to have psychiatric illnesses, hypertension, and a history of prior malignancy. HPos AA patients underwent operative intervention less often than HNeg AA patients (90.7% versus 97.7%;p<0.001). Overall, comparing HPos to HNeg patients, there was no difference in post-operative infections or mortality. CONCLUSION: HIV-positive status should not deter surgeons from offering definitive care for acute uncomplicated appendicitis.