Document Detail


Risk for hospital contact with infection in patients with splenectomy: a population-based cohort study.
MedLine Citation:
PMID:  19841456     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Splenectomy has been associated with increased risk for infection. OBJECTIVE: To assess the magnitude and duration of risk for hospital contact with infection associated with splenectomy. DESIGN: Population-based cohort study. SETTING: Denmark. PATIENTS: All 3812 persons in Denmark who underwent splenectomy from 1996 to 2005. Splenectomized patients were matched to 3 comparison cohorts: the general population, appendectomized patients, and unsplenectomized patients with indications for splenectomy. MEASUREMENTS: Relative risks were assessed for hospital contact involving any infection, pneumonia, and microbiologically confirmed bacteremia among 3812 splenectomized patients and their matched comparisons, during different follow-up periods and after regression analysis for confounder adjustment. RESULTS: The adjusted relative risk for any hospital contact with infection was highest within 90 days of splenectomy: 10.2% vs. 0.6% among general population comparisons (adjusted odds ratio, 18.1 [95% CI, 14.8 to 22.1]) and 10.2% vs. 4.2% among appendectomized patients (adjusted odds ratio, 2.4 [CI, 2.1 to 2.8]). The hazard of infection was 4.6-fold (CI, 3.8 to 5.5) higher in splenectomized patients than in general population comparisons from 91 to 365 days after splenectomy and 2.5 times (CI, 2.2 to 2.8) higher more than 365 days after splenectomy. The risks were similar for pneumonia and were higher for bacteremia. Markedly increased risks were also found when compared with those of appendectomized patients. Modest increases in infection risk were seen with splenectomy matched-indication comparisons (adjusted 90-day odds ratio, 1.7 [CI, 1.5 to 2.1]; hazard ratios, 1.5 [CI, 1.2 to 1.8] from 91 to 365 days after splenectomy and 1.2 [CI, 1.1 to 1.4] beyond 365 days after splenectomy). Relative risks for infection were highest in patients who had splenectomy because of hematologic disorders. LIMITATION: Increased surveillance among splenectomized patients may have affected the findings. CONCLUSION: Splenectomy is associated with increased long-term risk for infections involving hospital contact.
Authors:
Reimar W Thomsen; W Marieke Schoonen; Dóra K Farkas; Anders Riis; Jacob Jacobsen; Jon P Fryzek; Henrik Toft Sørensen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of internal medicine     Volume:  151     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-20     Completed Date:  2009-11-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  546-55     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Epidemiology, Aarhus University Hospital, Aalborg Hospital Science and Innovation Centre, Søndre Skovvej 15, Aalborg, Denmark. r.thomsen@rn.dk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Bacteremia / diagnosis,  epidemiology,  etiology
Child
Child, Preschool
Cohort Studies
Comorbidity
Denmark / epidemiology
Female
Hospitalization / statistics & numerical data*
Humans
Infant
Infection / diagnosis,  epidemiology*,  etiology
Male
Middle Aged
Pneumonia / diagnosis,  epidemiology,  etiology
Risk
Splenectomy / adverse effects*
Time Factors
Young Adult
Comments/Corrections
Summary for patients in:
Ann Intern Med. 2009 Oct 20;151(8):I42   [PMID:  19841440 ]

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


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