[Splenectomy in a large general hospital: often caused by iatrogenic injury, often causing multiple complications; poor adherence to post-operative guidelines for vaccination and prophylaxis].
OBJECTIVE
To assess the indications, complications and mortality associated with splenectomy in a large general hospital, and to evaluate adherence to guidelines for postoperative vaccination and prophylactic antibiotics.


METHODS
Retrospective, descriptive.


METHODS
Data were collected on 106 patients who underwent splenectomy between 1999 and 2004. Indications for surgery, complications, duration of hospitalisation, and vaccination status were investigated retrospectively. Patients were contacted by telephone for a structured interview regarding vaccination and antibiotic prophylaxis.


RESULTS
Of the 95 patients with sufficient data for analysis, 41 underwent elective surgery and 54 underwent non-elective surgery, including 37 who required splenectomy due to iatrogenic injury. Posteroperative complications arose in 45 patients, including 23 who developed serious complications. 10 patients died due to complications, including 7 who died within one month after the procedure. Vaccination coverage for the entire group was 58%.


CONCLUSIONS
In this large general hospital, splenectomy was often performed due to iatrogenic injury and was associated with a relatively high complication rate. Adherence to guidelines on vaccination and prophylactic antibiotics could be improved.
Albert Schweitzer Ziekenhuis, afd. Heelkunde, Postbus 444, 3300 AK Dordrecht.
J J I
JJ
Brandenburg
V M
VM
de Jong
R J
RJ
Oostenbroek
P J
PJ
Westenend
H M E
HM
Frenay
W L E M
WL
Hesp
P W
PW
Plaisier
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D005260:Female; D019983:Guideline Adherence; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013154:Spleen / Q000293:injuries* / Q000601:surgery; D013156:Splenectomy / Q000009:adverse effects*; D014611:Vaccination
D000900:Anti-Bacterial Agents