title: Splenectomy increases the subsequent risk of systemic lupus erythematosus.
abstract: Splenectomy may be necessary to treat systemic lupus erythematosus (SLE) patients with thrombocytopenia; however, whether performing a splenectomy on patients without SLE increases the subsequent risk of SLE remains unknown. Therefore, this study was conducted to determine the association between splenectomy and SLE. We conducted a cohort study by using data from the Taiwan National Health Institute Research Database to identify 10,298 patients with received a splenectomy between 2000 and 2006 and 41,192 participants without received a splenectomy who were selected by frequency matched based on sex, age, and the index year. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of developing SLE associated with splenectomy compared with patients who did not receive a splenectomy. During the study period, the overall incidence density rate of SLE was higher in the splenectomy cohort than in the non-splenectomy cohort (adjusted HR 10.55; 95 % CI 50.55-20.05). The incidence density rates of SLE in women and men who received a splenectomy were higher than those of patients who did not receive a splenectomy. Non-traumatic splenectomy increases the subsequent risk of SLE. The risk of SLE should be considered before performing a splenectomy, particularly in women and younger patients.
authors.affiliation: Department of Medical Education and Research, Puli Christian Hospital, Puli, Taiwan.|Department of Optometry, Central Taiwan University of Science and Technology, Taichung, Taiwan.|Center for General Education, National Taichung University of Science and Technology, Taichung, Taiwan.|The General Education Center, Chaoyang University of Technology, Taichung, Taiwan.|Department of General Education, National Chin-Yi University of Technology, Taichung, Taiwan.
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Hsu
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Hsuan-Ju
authors.initials: HJ
authors.lastname: Chen
authors.affiliation: Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan.
authors.forename: Chung Y
authors.initials: CY
authors.lastname: Hsu
authors.affiliation: Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan. d10040@mail.cmuh.org.tw.|Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. d10040@mail.cmuh.org.tw.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D017677:Age Distribution; D016009:Chi-Square Distribution; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D013156:Splenectomy / Q000009:adverse effects*; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
keywords: Non-traumatic; Splenectomy; Systemic lupus erythematosus