Risk Assessment System For Postoperative Concurrent Sepsis In HIV- Infected Trauma Patients

Background: Patients with acquired immunodeficiency syndrome (AIDS) are more prone to sepsis after trauma. No systematic evaluation system during the perioperative period is available for the risk assessment of posttraumatic sepsis with AIDS. Objective: This study aimed to investigate the risk factors for sepsis in human immunodeficiency virus (HIV) -infected trauma patients during the perioperative period. Methods: A retrospective analysis was performed based on the clinical data. A total of 89 HIV-infected trauma patients, who underwent surgical treatment at the Shanghai Public Health Clinical Center from January 2009 to December 2016, were divided into sepsis and non-sepsis groups according to the presence or absence of sepsis. A risk assessment table was designed to evaluate the scores of the two groups. Risk indicators included CD4+ T cell score, surgical grade score, surgical classification score, opportunistic infection score, organ function score, and comprehensive score. Results: Sepsis occurred in 18 patients. Statistically significant differences were observed in CD4+ T cell score, surgical grade score, surgical classification score, opportunistic infection score, organ function score, and comprehensive score between sepsis and nonsepsis groups. From ROC curve, the cutoff value of comprehensive score was 8.5, the sensitivity value was 1, the specificity value was 0.92, and the area under the curve was 0.99. Conclusions : The risk of sepsis in HIV-infected trauma patients can be predicted through the comprehensive score. Therefore, if the comprehensive score is more than 8.5, relevant response measures are recommended for the prognosis of sepsis in HIV-infected trauma patients .