title: Splenectomy for trauma increases the rate of early postoperative infections.
abstract: Little is known what effect splenectomy for trauma has on early postoperative infectious complications. Our aim was to determine if splenectomy increases early postoperative infections in trauma patients undergoing laparotomy. We reviewed all trauma patients undergoing splenectomy from June 2002 through December 2004. Each splenectomy patient was matched to a unique trauma patient who underwent laparotomy without splenectomy based on age, gender, mechanism of injury, injury severity score, and presence of colon or other hollow visceral injury. Outcomes included infectious complications including pneumonia, urinary tract infection, bacteremia, and intra-abdominal abscess, as well as mortality. There were 98 splenectomy patients and 98 controls. The splenectomy patients had more overall infectious complications (45% vs 30%, P = 0.04) trended toward more urinary tract infections (12% vs 5%, P = 0.12), and more often had pneumonia (30% vs 14%, P = 0.02). Additionally, more splenectomy patients developed multiple infections (20% vs 7%, P = 0.01). There was no difference in mortality (11% vs 8%, P = 0.63). Splenectomy is associated with an increase in infectious complications after laparotomy for trauma. More specifically, splenectomy patients more often develop pneumonia and multiple infections. This increase in infections is not associated with increased mortality.
authors.affiliation: Department of Surgery, Division of Trauma and Critical Care, Los Angeles County/University of Southern California Medical Center, 90033, USA.
authors.forename: James
authors.initials: J
authors.lastname: Wiseman
authors.forename: Carlos V R
authors.initials: CV
authors.lastname: Brown
authors.forename: Janie
authors.initials: J
authors.lastname: Weng
authors.forename: Ali
authors.initials: A
authors.lastname: Salim
authors.forename: Peter
authors.initials: P
authors.lastname: Rhee
authors.forename: Demetrios
authors.initials: D
authors.lastname: Demetriades
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology; D000328:Adult; D016470:Bacteremia / Q000209:etiology; D001424:Bacterial Infections / Q000209:etiology*; D016022:Case-Control Studies; D002423:Cause of Death; D003106:Colon / Q000293:injuries; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D011014:Pneumonia / Q000209:etiology; D011183:Postoperative Complications; D012189:Retrospective Studies; D013156:Splenectomy; D013530:Surgical Wound Infection / Q000209:etiology; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000209:etiology; D014947:Wounds and Injuries / Q000601:surgery*