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Diverticulitis in HIV ‐infected patients within the U nited S tates
Author(s) -
Cronley K,
Wenzke J,
Hussan H,
Vasquez AM,
Hinton A,
ElDika S,
Conwell DL,
Krishna SG,
Stanich PP
Publication year - 2016
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12304
Subject(s) - medicine , diverticulitis , odds ratio , confidence interval , mortality rate , population , human immunodeficiency virus (hiv) , multivariate analysis , immunology , environmental health
Objectives Diverticulitis in patients on immunosuppressant therapy has been associated with increased mortality, but there are no data for HIV ‐infected patients. Our aim was to compare the outcomes of hospitalizations for diverticulitis in patients with and without HIV infection. Methods Cross‐sectional study of hospitalizations in the U nited S tates accessed through the N ationwide I npatient S ample, H ealthcare C ost and U tilization P roject. Patients hospitalized for diverticulitis in 2007–2011 were included in the analysis. The primary outcomes of interest were mortality and surgical therapy rates. Patients from 2003 to 2011 were utilized to analyse trends in prevalence. Results There were 2375 patients with HIV infection hospitalized for diverticulitis and 1 160 391 patients without HIV infection hospitalized for diverticulitis from 2007 to 2011. The patients with HIV infection were younger and more likely to be male and nonwhite ( P < 0.001 for all). There were also differences in insurance types ( P < 0.001) and hospitals [size ( P = 0.008), type ( P < 0.001) and location ( P < 0.001)]. After multivariate analysis, patients with diverticulitis and HIV infection had a significantly increased in‐hospital mortality rate [odds ratio ( OR ) 3.94 (95% confidence interval, CI , 1.52–10.20)] and a lower rate of surgical intervention [ OR 0.74 (95% CI 0.57–0.95)]. From 2003 to 2011, there was a linear increasing trend in the prevalence of HIV infection among patients hospitalized for diverticulitis ( P < 0.001). Conclusions HIV ‐infected patients with diverticulitis had increased mortality and received less surgical treatment in comparison to the general population. Diverticulitis in HIV ‐infected patients increased in prevalence over the study period.