Risk of infection and death among post-splenectomy patients.
OBJECTIVE
The true incidence of post-splenectomy sepsis remains undetermined.


METHODS
An English literature review on post-splenectomy sepsis was undertaken by means of databases of MEDLINE for the period 1966-96. The data registered included age at splenectomy, indication for splenectomy, incidence of infection and death, interval between splenectomy and infection, and microbial aetiology.


RESULTS
The reports include 19 680 patients having undergone splenectomy with a median follow up of 6.9 years. The incidence of infection after splenectomy was 3.2% and the mortality rate was 1.4%. Only 6942 reports were sufficiently detailed to allow useful analysis. The incidence of infection among children and adults was similar, 3.3% and 3.2%, respectively. However, the death rates among children were higher than adults (1.7% vs. 1.3%). The incidence of infection was highest among patients with thalassemia major (8.2%), and sickle-cell anaemia (7.3%). The highest mortality rates were observed among patients with thalassaemia major (5.1%), and sickle-cell anaemia (4.8%).


CONCLUSIONS
The incidence of sepsis among post-splenectomy patients is low, however, it carries a high mortality rate especially among children with hematological disorders.
Bisharat
N
N
Infectious Diseases Unit, Ha'Emek Medical Center, the Rappaport Faculty of medicine, Afula, Israel. naiel@rannet.com
Omari
H
H
Lavi
I
I
Raz
R
R
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000755:Anemia, Sickle Cell / Q000601:surgery; D002648:Child; D006801:Humans; D015994:Incidence; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000382:microbiology* / Q000401:mortality; D013156:Splenectomy; D013789:Thalassemia / Q000601:surgery