TY - JOUR
T1 - Splenectomy is associated with higher infection and pneumonia rates among trauma laparotomy patients
AU - Fair, Kelly A.
AU - Connelly, Christopher R.
AU - Hart, Kyle D.
AU - Schreiber, Martin A.
AU - Watters, Jennifer
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/5
Y1 - 2017/5
N2 - 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.
AB - 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.
KW - Infection
KW - Pneumonia
KW - Splenectomy
KW - Trauma
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U2 - 10.1016/j.amjsurg.2017.04.001
DO - 10.1016/j.amjsurg.2017.04.001
M3 - Article
C2 - 28433229
AN - SCOPUS:85017517504
SN - 0002-9610
VL - 213
SP - 856
EP - 861
JO - American journal of surgery
JF - American journal of surgery
IS - 5
ER -