An HIV-positive status and short term perioperative mortality – a systematic review

Background: A contemporary summary describing the impact of an HIV-positive status on short term perioperative mortality is lacking. Objective: To collate and summarise published data related to short term perioperative mortality from studies comparing HIVpositive and HIV-negative patient groups. Method: We conducted a systematic review of the published literature by performing structured searches of two medical literature databases. Pre-defined inclusion/exclusion criteria were used to identify potentially relevant manuscripts. Further screening of the reference lists of eligible manuscripts, as well as a prior systematic review was also performed to identify any additional manuscripts that may have been relevant. Data retrieved from eligible manuscripts included, amongst other variables: study and population descriptions, surgical category (cardiac or noncardiac surgery), as well the incidence of short term perioperative mortality. Crude odds ratios were calculated for each eligible manuscript to describe the association between HIV status and short term perioperative mortality. Results: Our systematic review consisted of 12 manuscripts describing 12 studies. The majority of manuscripts described studies conducted in countries with a low burden of HIV infection. Most manuscripts described findings from a noncardiac surgery setting. Crude associations between an HIV-positive status and a higher odds of short term perioperative mortality were noted for data from 2 of the 12 manuscripts, while the association was unclear in the remaining 10 manuscripts. Conclusion: Evidence supporting a higher odds of short term perioperative mortality in patients with an HIV-positive status is unconvincing. Further research is required to adequately investigate this.