Document Detail


Delayed adverse vascular events after splenectomy in hereditary spherocytosis.
MedLine Citation:
PMID:  18485083     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is probable that the variety and frequency of delayed adverse vascular events after splenectomy are underappreciated. Splenectomy is performed for a wide variety of conditions, and delayed postsplenectomy hazards are not often studied. OBJECTIVE: To estimate the relative risk of adverse vascular events in members of hereditary spherocytosis families who have or have not had a splenectomy. METHODS: Members of families in which hereditary spherocytosis exists were systematically questioned about adverse vascular events. RESULTS: The cumulative incidence of arterial and venous events at age 70 years was greater in persons who had undergone a splenectomy for spherocytosis (arterial, 22% females, 32% males; venous, 20% females, 19% males) than in affected persons who did not undergo splenectomy (arterial, 3% females, 2% males; venous, 6% females, 4% males) or non-affected family members (arterial, 10% females, 17% males; venous, 4% females, 12% males). Affected subjects who undergo splenectomy are at greatly increased risk of arterial events as compared to affected subjects who do not undergo splenectomy [arterial, hazard ratio (HR) 7.2, 95% confidence interval (CI) 2.8-17.2; venous, HR 3.3, 95% CI 1.1-9.8]. CONCLUSION: There is a significant, long-lasting, increased risk of adverse arterial and venous thromboembolic events after splenectomy performed for hereditary spherocytosis. A review of the literature indicates that this is also true when splenectomy is performed for several other indications.
Authors:
R F Schilling; R E Gangnon; M I Traver
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Publication Detail:
Type:  Journal Article     Date:  2008-05-15
Journal Detail:
Title:  Journal of thrombosis and haemostasis : JTH     Volume:  6     ISSN:  1538-7836     ISO Abbreviation:  J. Thromb. Haemost.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-27     Completed Date:  2008-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101170508     Medline TA:  J Thromb Haemost     Country:  England    
Other Details:
Languages:  eng     Pagination:  1289-95     Citation Subset:  IM    
Affiliation:
Department of Medicine, Emeritus, University of Wisconsin-Madison, Madison, WI, USA. rfsmd@medicine.wisc.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Aged
Female
Humans
Hypertension, Pulmonary / etiology
Male
Middle Aged
Osteonecrosis / etiology
Postoperative Complications / etiology*
Priapism / etiology
Proportional Hazards Models
Prospective Studies
Pulmonary Embolism / etiology
Risk Factors
Spherocytosis, Hereditary / complications*,  surgery*
Splenectomy / adverse effects*
Time Factors
Vascular Diseases / etiology*
Venous Thromboembolism / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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