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Related Experiment Videos

Postsplenectomy sepsis and its mortality rate: actual versus perceived risks.

R J Holdsworth1, A D Irving, A Cuschieri

  • 1University Department of Surgery, Ninewells Hospital and Medical School, Dundee, UK.

The British Journal of Surgery
|September 1, 1991
PubMed
Summary

Splenectomy (spleen removal) poses a higher sepsis risk in children, especially those under five. Adults face a lower risk, but coexisting conditions like liver disease increase susceptibility in all age groups.

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Area of Science:

  • Medicine
  • Infectious Diseases
  • Surgical Outcomes

Background:

  • The spleen plays a role in immune function, and its removal (splenectomy) can impact susceptibility to infections.
  • Postspleen removal sepsis has been a recognized complication, particularly in pediatric populations.

Purpose of the Study:

  • To critically review the literature on postsplenectomy sepsis from 1952 to 1987.
  • To analyze the incidence, mortality, and types of infections following splenectomy across different age groups.

Main Methods:

  • A collective critical literature review was performed.
  • Analysis focused on 5902 detailed reports from a cohort of 12,514 splenectomy patients.

Main Results:

  • Infection rates post-splenectomy were 4.4% in children (<16 years) and 0.9% in adults, with corresponding mortality rates of 2.2% and 0.8%.

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  • Severe infections were rare in adults and older children but notably higher in infants (15.7%) and children under 5 (10.4%).
  • Children predominantly developed meningitis, while adults were more prone to fatal septicemia; children showed higher susceptibility to pneumococcal sepsis.

    • Conclusions:

    • Severe postsplenectomy infection is uncommon in adults and older children with benign disease but a significant risk in infants and very young children.
    • Age influences the type and outcome of postsplenectomy infections, with children experiencing meningitis and adults septicemia.
    • Coexisting conditions, such as hepatic disease, substantially increase the risk of infection after splenectomy.