1. The effects of HIV/AIDS on the clinical profile and outcomes post pericardiectomy of patients with constrictive pericarditis: a retrospective review.
- Author
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Naidoo DP, Laurence G, Sartorius B, and Ponnusamy S
- Subjects
- Adult, Aged, Anti-HIV Agents therapeutic use, Antitubercular Agents therapeutic use, Female, HIV Infections diagnosis, HIV Infections drug therapy, HIV Infections mortality, Hospital Mortality, Humans, Male, Middle Aged, Pericarditis, Constrictive diagnosis, Pericarditis, Constrictive microbiology, Pericarditis, Constrictive mortality, Pericarditis, Tuberculous diagnosis, Pericarditis, Tuberculous microbiology, Pericarditis, Tuberculous mortality, Retrospective Studies, Risk Assessment, Risk Factors, South Africa epidemiology, Time Factors, Treatment Outcome, Young Adult, Coinfection, HIV Infections epidemiology, Pericardiectomy adverse effects, Pericardiectomy mortality, Pericarditis, Constrictive surgery, Pericarditis, Tuberculous surgery
- Abstract
Objective: The clinical profile and surgical outcomes of patients with constrictive pericarditis were compared in HIV-positive and -negative individuals., Methods: This study was a retrospective analysis of patients diagnosed with constrictive pericarditis at Inkosi Albert Luthuli Central Hospital, Durban, over a 10-year period (2004-2014)., Results: Of 83 patients with constrictive pericarditis, 32 (38.1%) were HIV positive. Except for pericardial calcification, which was more common in HIV-negative subjects (n = 15, 29.4% vs n = 2, 6.3%; p = 0.011), the clinical profile was similar in the two groups. Fourteen patients died preoperatively (16.9%) and three died peri-operatively (5.8%). On multivariable analysis, age (OR 1.17; 95% CI: 1.03-1.34; p = 0.02), serum albumin level (OR 0.63; 95% CI: 0.43-0.92; p = 0.016), gamma glutamyl transferase level (OR 0.97; 95% CI: 0.94-0.1.0; p = 0.034) and pulmonary artery pressure (OR 1.49; 95% CI: 1.07-2.08; p = 0.018) emerged as independent predictors of pre-operative mortality rate. Peri-operative complications occurred more frequently in HIV-positive patients [9 (45%) vs 6 (17.6%); p = 0.030]., Conclusions: Without surgery, tuberculous constrictive pericarditis was associated with a high mortality rate. Although peri-operative complications occurred more frequently, surgery was not associated with increased mortality rates in HIV-positive subjects.
- Published
- 2019
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