Splenectomy is associated with higher infection and pneumonia rates among trauma laparotomy patients

Abstract Splenectomy increases lifetime risk of thromboembolism (VTE) and is associated with long-term infectious complications, primarily, overwhelming post-splenectomy infection (OPSI). Our objective was to evaluate risk of VTE and infection at index hospitalization post-splenectomy. Retrospective...

Full description

Saved in:
Bibliographic Details
Published inThe American journal of surgery Vol. 213; no. 5; pp. 856 - 861
Main Authors Fair, Kelly A, Connelly, Christopher R, Hart, Kyle D, Schreiber, Martin A, Watters, Jennifer M
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.05.2017
Elsevier Limited
Subjects
Online AccessGet full text

Cover

Loading…
More Information
Summary:Abstract Splenectomy increases lifetime risk of thromboembolism (VTE) and is associated with long-term infectious complications, primarily, overwhelming post-splenectomy infection (OPSI). Our objective was to evaluate risk of VTE and infection at index hospitalization post-splenectomy. Retrospective review of all patients who received a laparotomy in the NTDB. Propensity score matching for splenectomy was performed, based on ISS, abdominal abbreviated injury score >3, GCS, sex and mechanism. Major complications, VTE, and infection rates were compared. Multiple logistic regression models were utilized to evaluate splenectomy-associated complications. 93,221 laparotomies were performed and 17% underwent splenectomy. Multiple logistic regression models did not demonstrate an association between splenectomy and major complications (OR 0.96, 95% CI 0.91-1.03, p =0.25) or VTE (OR 1.05, 95% CI 0.96-1.14, p =0.33). Splenectomy was independently associated with infection (OR 1.07, 95% CI 1.00-1.14, p =0.045). Subgroup analysis of patients with infection demonstrated that splenectomy was most strongly associated with pneumonia (OR 1.41, 95% CI 1.26-1.57, p <0.001). Splenectomy is not associated with higher overall complication or VTE rates during index hospitalization. However, splenectomy is associated with a higher rate of pneumonia.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Undefined-1
ObjectType-Feature-3
content type line 23
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2017.04.001