Splenectomy is associated with a higher risk for venous thromboembolism: A prospective cohort study.
BACKGROUND
Thrombocytosis following splenectomy is a common occurrence. Whether this thrombocytosis leads to a higher risk for venous thromboembolism (VTE) remains unclear. This investigation aimed to determine if splenectomy increases the risk for VTE.


METHODS
This was a prospective study conducted in the SICU between 1/2011 and 11/2013 investigating the VTE risk in patients undergoing a splenectomy compared with those undergoing any other abdominal procedure.


RESULTS
In total 2503 patients were admitted to the SICU: 37 (2%) after a splenectomy and 638 (26%) after any other abdominal surgery. Splenectomy patients had a higher incidence of VTE compared to patients undergoing any other abdominal procedure (29.7% vs. 12.1%, p < 0.01). After adjustment, splenectomy was associated with a higher adjusted risk for VTE compared to the no-splenectomy group (AOR [95% CI]: 2.6 [1.2, 5.9], p = 0.02). Reactive thrombocytosis did not predict the development of VTE.


CONCLUSIONS
Splenectomy increases the risk for VTE, however reactive thrombocytosis is not associated with this higher incidence. Further investigations are required to characterize the pathophysiologic mechanisms of VTE development following splenectomy.
Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: Debora.Lee@ucla.edu.
Debora H
DH
Lee
Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: gbarmparas@gmail.com.
Galinos
G
Barmparas
Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: nfierro@ucla.edu.
Nicole
N
Fierro
Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: beatrice.sun@cshs.org.
Beatrice J
BJ
Sun
Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: sogolashrafian@gmail.com.
Sogol
S
Ashrafian
Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: tong.li@ucla.edu.
Tong
T
Li
Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: Eric.Ley@cshs.org.
Eric J
EJ
Ley
D000368:Aged; D002140:California / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013156:Splenectomy / Q000009:adverse effects*; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000209:etiology*
Anticoagulation; Prophylaxis; Splenectomy; Thrombocytosis; Venous thromboembolism