Adherence to vaccination guidelines post splenectomy: A five year follow up study

Area of Science:

• Infectious Diseases
• Surgical Outcomes
• Public Health

Background:

• Splenectomy significantly increases infection risk, with overwhelming post-splenectomy infection (OPSI) having a high mortality rate (up to 80%).
• Adherence to national guidelines for vaccinations and antibiotic prophylaxis is crucial for managing infection risk in asplenic patients.

Purpose of the Study:

• To evaluate adherence to national vaccination and antibiotic guidelines in patients who have undergone splenectomy.
• To identify areas for improvement in the management of splenectomized patients to reduce infection risks.

Main Methods:

• A retrospective study of 100 patients undergoing splenectomy (emergency and elective) over five years.
• Review of hospital and GP records for adherence to pre, intra, and postoperative vaccination, thromboprophylaxis, and antibiotic guidance.
• Follow-up of patients for five years to assess long-term management and outcomes.

Main Results:

• High adherence (91.5%) to peri-operative vaccinations (Haemophilus influenzae B, meningococcal C, pneumococcus) and thromboprophylaxis (99%).
• Good rates of long-term antibiotic prophylaxis (95%) and annual influenza vaccination (95%), but lower rates of emergency antibiotic supplies (23%).
• 84% of eligible patients received a five-year pneumococcal booster vaccination.

Conclusions:

• While vaccination and long-term antibiotic prophylaxis adherence are generally good, improvements are needed in emergency antibiotic provision.
• A multidisciplinary approach, standardized protocols, patient education, and a splenectomy register are recommended to optimize care for this vulnerable patient group.