P50 – Outcome of Human Immuno-Deficiency Virus Infected Patients following Traumatic Brain Injury

Author(s):
Nasim Ahmed, Yen-Hong Kuo, John Davis, Jersey Shore University Medical Center

Background: Recent reports showed no significant difference in mortality following traumatic injuries whether patient had HIV infection or not.
The purpose of this study was to evaluate the mortality of HIV infected patients who sustained traumatic brain injury.

Hypothesis: No difference in outcome following head injury regardless of HIV infection

Methods: Last ten years data of all adult head injury patients who were admitted to our institution was analyzed. Demography and clinical information of HIV infected patients (Group1) were compared with non-HIV infected patients (Group 2). Outcome was in-hospital mortality and hospital length of stay (LOS). Data was analyzed using Wilcoxon rank sum test, Chi-square test and Fisher exact test. The median total hospital days were estimated using the Kaplan-Meier procedure. The standard errors were estimated using the Greenwood formula. The log-rank test was used to compare the total hospital days between groups. A p-value of 0.05 or less was considered an indication of statistical significance.

Results: One thousand eight hundred and ten adult patients were admitted to the hospital following traumatic head injury in last ten years. The prevalence of HIV infected patient in this cohort was 16 out of 1810 (0.88%). There were no significant differences between the groups regarding the distribution of traumatic brain injury [Subdural hematoma (P=0.35), Epidural hematoma (P=1.00), Subarachnoid hemorrhage (P=1.00), Brain contusion (P=1.00), Diffuse axonal injury (P=1.00)], female gender [(43.5%) versus (18.8%), P=0.08] and initial Glasgow Coma Scale (GCS) (P=0.32). However, there were significant differences between the groups regarding age [ 48.5 {44.3, 55.3} versus 67.5 {45,82}, P=0.005], and race, black or African American [31.2% versus 7.3%, P=0.06]. There were no significant differences in term of mortality (P=0.24), LOS (P=0.87), or development of Acute respiratory distress syndrome (P=1.00).

Conclusions: HIV status did not impact in-Hospital mortality and hospital length of stay following traumatic brain injury.