title: Splenectomy in older adults: indications and clinical outcomes.
abstract: The aim of this study was to improve the understanding of the indications and associated outcomes among older adults undergoing splenectomy. Data regarding patients of age ≥60 years treated between 1998 and 2008 were reviewed. Fifty patients (age 71.6 ± 8) were identified. Common indications for splenectomy included idiopathic thrombotic purpura (26.0 %) and lymphoma (28.0 %). Patient co-morbidities included hypertension (54 %), coronary artery disease (24 %) and diabetes mellitus (20 %). Twenty-seven patients (54 %) underwent laparoscopic surgery; 23 (46 %) had open procedures; more than half of open splenectomies were conversions from attempted laparoscopy. Mean post-operative length of stay (LOS) was 5.9 ± 5 days (range 1-21). Two patients died in hospital; an additional three died within 6 months. Five patients were discharged to an extended care facility (ECF). Three patients required readmission within 30 days. Increased age was associated with need for ECF (p = 0.01). Increasing LOS, but not age, was associated with 6-month mortality (p = 0.04). Although we noted a 10 % in hospital mortality rate, splenectomy appears to be safe for carefully selected older adults.
authors: University of Michigan Medical School, Ann Arbor, MI, USA.
authors: Lane L
authors: LL
authors: Frasier
authors: Preeti N
authors: PN
authors: Malani
authors: Kathleen M
authors: KM
authors: Diehl
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000150:complications / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications / Q000401:mortality / Q000601:surgery*; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome