Incidence and risk factors for sepsis after childhood splenectomy

Journal of Pediatric Surgery
Arin L MadenciBrent R Weil

Abstract

Children who have undergone splenectomy may develop impaired immunologic function and heightened risk of overwhelming postsplenectomy infection. We sought to define the long-term rate of and risk factors for postsplenectomy sepsis. We leveraged the Military Health System Data Repository, a nationally representative claims database including >3 million children registered as dependents of members of the United States Armed Services (2005-2014). Inclusion criterion was splenectomy at age 18 years or prior. The primary outcome was hospitalization for sepsis. Among 195 children who underwent splenectomy, 7% (n = 13) were hospitalized with sepsis, with an incidence of 1.8 (95% CI = 1.0-3.1) events per 100 person-years. The median time to sepsis was 224 days (IQR = 109-606) and 38% (5/13) of events occurred within the first postsplenectomy year. The postsplenectomy mortality rate was 1% (n = 3). After adjusting for underlying diagnosis, older age at splenectomy (HR = 0.90 per year, 95% CI = 0.81-0.99) was associated with decreased hazard of sepsis. In a contemporary national cohort, the prevalence of postsplenectomy sepsis was 7% (1.8 events per 100 person-years). Although most presented during the first year after splenectomy, many ...Continue Reading

Citations

Feb 13, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Roy SpijkermanIvar G J M de Bruin
Jul 10, 2020·Clinical & Translational Immunology·Gintare LasaviciuteAnna Nilsson
Aug 21, 2020·BMC Health Services Research·Tracey Pérez KoehlmoosJoel S Weissman
Nov 8, 2019·Tissue Engineering. Part a·Kristin GeeTracy C Grikscheit
Aug 18, 2021·Kidney Medicine·Jenna M NortonTracey P Koehlmoos
Dec 4, 2020·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Niruthiga ArunagiriUNKNOWN SIOP-Europe Radiation Oncology Working Group

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