Document Detail


Systemic pneumococcal disease after staging splenectomy for Hodgkin's disease 1969-1980 without pneumococcal vaccine protection: a follow-up study 1994.
MedLine Citation:
PMID:  9111586     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We surveyed, during 1994, all 325 patients who underwent staging laparotomy with splenectomy for Hodgkin's disease in Norway 1969-80, before pneumococcal vaccine was available in this country. The patients were thus not immunized preoperatively. Of 162 patients (49.8%) who died before 1994, 8 (2.4% of the total study) died from pneumococcal septicaemia and 16 (6.2%) from infections totally. Of 163 patients (50.2%) who were alive in 1994, 158 cooperated and filled in a questionnaire: 22 had been hospitalized for serious infections; 2 with pneumococcal septicaemia, and 6 with pneumonia, although lacking a specified microbiological diagnosis. We observed 325 patients representing 4420 patient-years, 3066 patient-years among survivors and 1354 patient-years among the dead. This resulted in an incidence rate of systemic pneumococcal disease of 226 per 100,000 patient-years, which is a relative risk of 20.5 compared to the general Norwegian population during 1994. Septicaemia for these patients most often had an abrupt clinical start even for relapse-free individuals and occurred from 2 to 17 yr after splenectomy (mean 10 yr). The risk of developing an overwhelming pneumococcal septicaemia with high case-fatality in asplenic patients seems to persist for these patients at about the same level even 15-20 yr after splenectomy. Only 12.7% of the survivors had been given pneumococcal vaccine in the autumn of 1993. Despite the fact that medical journals and media in Norway focused upon the problem of pneumococcal disease in asplenic individuals in the autumn of 1993 and spring of 1994, a substantial proportion of these patients (55.3%) still remained unimmunized when interviewed in the autumn of 1994. None of our systemic pneumococcal disease patients was vaccinated. Our data underline the need for prophylactic immunization with effective vaccines against pneumococcal infection in splenectomized Hodgkin's disease patients.
Authors:
A Foss Abrahamsen; E A Høiby; E Hannisdal; O G Jørgensen; H Holte; V Hasseltvedt; H Høst
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of haematology     Volume:  58     ISSN:  0902-4441     ISO Abbreviation:  Eur. J. Haematol.     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-05-12     Completed Date:  1997-05-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8703985     Medline TA:  Eur J Haematol     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  73-7     Citation Subset:  IM    
Affiliation:
Department of Oncology, Norwegian Radium Hospital, Oslo, Norway.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Bacteremia / epidemiology,  mortality
Bacterial Vaccines
Follow-Up Studies
Hodgkin Disease / pathology,  surgery*
Humans
Middle Aged
Neoplasm Staging
Norway / epidemiology
Pneumococcal Infections / epidemiology*,  mortality,  prevention & control
Postoperative Complications*
Questionnaires
Splenectomy*
Survival Rate
Time Factors
Chemical
Reg. No./Substance:
0/Bacterial Vaccines

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