• Ned Tijdschr Geneeskd · May 2008

    [Splenectomy in a large general hospital: often caused by iatrogenic injury, often causing multiple complications; poor adherence to post-operative guidelines for vaccination and prophylaxis].

    • J J I Brandenburg, V M de Jong, R J Oostenbroek, P J Westenend, H M E Frenay, W L E M Hesp, and P W Plaisier.
    • Albert Schweitzer Ziekenhuis, afd. Heelkunde, Postbus 444, 3300 AK Dordrecht.
    • Ned Tijdschr Geneeskd. 2008 May 17; 152 (20): 1164-8.

    ObjectiveTo assess the indications, complications and mortality associated with splenectomy in a large general hospital, and to evaluate adherence to guidelines for postoperative vaccination and prophylactic antibiotics.DesignRetrospective, descriptive.MethodData were collected on 106 patients who underwent splenectomy between 1999 and 2004. Indications for surgery, complications, duration of hospitalisation, and vaccination status were investigated retrospectively. Patients were contacted by telephone for a structured interview regarding vaccination and antibiotic prophylaxis.ResultsOf the 95 patients with sufficient data for analysis, 41 underwent elective surgery and 54 underwent non-elective surgery, including 37 who required splenectomy due to iatrogenic injury. Posteroperative complications arose in 45 patients, including 23 who developed serious complications. 10 patients died due to complications, including 7 who died within one month after the procedure. Vaccination coverage for the entire group was 58%.ConclusionIn this large general hospital, splenectomy was often performed due to iatrogenic injury and was associated with a relatively high complication rate. Adherence to guidelines on vaccination and prophylactic antibiotics could be improved.

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