Long-term risk of acute coronary syndrome in splenectomized patients due to splenic injury.
We aimed to assess the magnitude and duration of risk of acute coronary syndrome (ACS) associated with splenectomy for splenic injury.We identified 5139 splenectomized patients (the splenectomy cohort) to compare with 2 other cohorts for assessing the magnitude and risk of ACS: the first cohort comprising subjects without splenic injury and without splenectomy (control cohort), and the second cohort comprising nonsplenectomized patients with splenic injury (nonsplenectomy cohort; n = 6391). For each splenic injury patient (n = 11530), 4 control comparisons were frequency-matched by the year of index date, age, and sex (n = 46120).The adjusted risk of ACS was significantly higher in the splenectomy group than in the control group (2.08 vs 1.68 per 1000 person-years; adjusted hazard ratio [HR], 1.30; 95% confidence interval [CI], 1.01-1.68). The sex-specific data showed that the adjusted HR for the splenectomy group, compared with the control group, was 1.29 in men (95% CI, 0.97-1.73) and 1.36 in women (95% CI, 0.79-2.33). The age-specific analyses failed to demonstrate a significantly higher adjusted HR of ACS in the splenectomized patients in any age subgroup, compared with their counterparts in the control group. Furthermore, no difference in the risk of ACS was detected between the splenectomy and nonsplenectomy cohorts within the splenic injury patients.In comparison with the control cohort, patients undergoing splenectomy for splenic injury exhibited an elevated risk of ACS.
From the Department of Surgery, E-Da Hospital and I-Shou University, Kaohsiung (M-ST, S-EC); Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei (H-SL); Department of Surgery, Organ Transplantation Center, China Medical University Hospital (L-BJ); Graduate Institute of Clinical Medical Science, China Medical University (L-BJ, C-HK); Management Office for Health Data, China Medical University Hospital (C-LL); College of Medicine, China Medical University (C-LL); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK).
Ming-Shian
MS
Tsai
Sheng-En
SE
Chou
Hong-Shiee
HS
Lai
Long-Bin
LB
Jeng
Cheng-Li
CL
Lin
Chia-Hung
CH
Kao
D054058:Acute Coronary Syndrome / Q000453:epidemiology*; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D013154:Spleen / Q000293:injuries*; D013156:Splenectomy / Q000706:statistics & numerical data*