Impact of HIV and AIDS in Short Term In-Hospital Outcomes in Patients Undergoing Carotid Artery Stenting

Background:
Carotid artery stenting (CAS) is one of the primary methods of interventions in carotid artery stenosis. Several studies have previously explored the different predictors of poor outcomes CAS. Yet, there is a sparse amount of literature that exists reporting the impact that HIV and AIDS have on CAS. This study aims to further the understanding of this intervention on in-hospital outcomes by focusing on the impact of pre-existing HIV and AIDs infections.

Methods:
This study used ICD9 codes and data from the Nationwide Inpatient Sample (2012-14) to identify adults diagnosed with symptomatic carotid artery disease who were a underwent CAS. Patients missing important clinical identifiers (age, gender, death, race) and had underwent carotid endarterectomy were excluded. Hospital length of stay (LOS), total inpatient charges, mortality, and average age at admission were assessed. Pearson’s chi-squared test and independent t-test were used to analyze the data

Results:
1,055 patient encounters were identified with the diagnosis symptomatic carotid artery disease with concomitant HIV and AIDS who underwent CAS. Increased mortality was observed in patients who had HIV/AIDs vs those who did not (20.9% vs 4.0% p=0.000). Increased total inpatient charges was observed in patients who had HIV/AIDS vs those who did not ($236,303 vs $131,415, 95% CI: -144,977 to -64,798: p=0.000). Increased LOS was observed in patients who had HIV/AIDS vs those who did not (12.88 vs 7.92, 95% CI:-7.355 to -3.175: p=0.000).

Conclusions:
Concomitant HIV or AIDs patients undergoing CAS had a significantly higher mortality, length of stay, and total inpatient charges accumulated. The results of these study can lead to better awareness and help assist clinicians in making important decisions with pre- and post-procedural optimization of HIV in patients undergoing CAS.