title: [Long-term infectious risks after splenectomy: A retrospective cohort study with up to 10 years follow-up].
abstract: BACKGROUND
  Although most infections occur within the first 2 years after splenectomy, the relatively short follow-up reported in many studies may underestimate the frequency of infections. The objective of the study was to determine the incidence of infective outcomes and factors associated with infection after splenectomy by studying a group of patients who underwent splenectomy over a 10-year period.
  
  
  METHODS
  A retrospective and monocentric study of patients who underwent splenectomy between January 1st, 1997 and December 31st, 2004 in a French university hospital. Age, sex, indication for splenectomy, infectious events, death, vaccination and antibiotic prophylaxis were collected in January 2015.
  
  
  RESULTS
  One hundred and sixty-five patients were included. The most common reasons for splenectomy were therapeutic hematological indications (37.5%). Ninety-seven per cent received pneumococcal vaccine. Prophylactic antibiotics were prescribed in 78% of patients. Thirty-seven patients had 42 severe infections with a median incidence rate of 4 years after splenectomy (2 days-12 years). The rate of infection after splenectomy declined over time but 57% occurred after 2 years and 14.3% after 10 years. Respiratory infections were the most common sites of infections. The incidence of infection differed according to age was highest among the elderly (HR=6.2; 95%CI: 1.4-27.1; after 65 years old) and underlying reason for splenectomy (P=0.02). There is no difference with or without prophylactic antibiotics.
  
  
  CONCLUSIONS
  After splenectomy, the incidence of severe infection declined over time but can occur after 10 years. The onset of infection is linked to age and reason for splenectomy.
authors.affiliation: Service de médecine interne, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France. Electronic address: etienne.meriglier@sfr.fr.
authors.forename: E
authors.initials: E
authors.lastname: Meriglier
authors.affiliation: Service de médecine interne, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France.
authors.forename: M
authors.initials: M
authors.lastname: Puyade
authors.affiliation: Service de chirurgie viscérale, centre hospitalier universitaire de Poitiers, Poitiers, France.
authors.forename: M
authors.initials: M
authors.lastname: Carretier
authors.affiliation: Service de maladies infectieuses et tropicales, centre hospitalier universitaire Poitiers, Poitiers, France.
authors.forename: F
authors.initials: F
authors.lastname: Roblot
authors.affiliation: Service de médecine interne, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France.
authors.forename: P
authors.initials: P
authors.lastname: Roblot
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013156:Splenectomy / Q000009:adverse effects* / Q000706:statistics & numerical data*; D013997:Time Factors; D055815:Young Adult
keywords: Infection; Splenectomy; Splénectomie; Vaccination