Splenic Embolization After Trauma: An Opportunity to Improve Best Immunization Practices

Area of Science:

• Trauma surgery
• Immunology
• Public health

Background:

• The spleen is the second most commonly injured solid organ in blunt abdominal trauma.
• Splenic rupture can be managed by splenectomy or splenic embolization.
• Advisory Committee on Immunization Practices (ACIP) guidelines recommend treating patients with >50% splenic mass loss as asplenic.

Purpose of the Study:

• To evaluate immunization compliance in trauma patients who underwent splenic embolization.
• To determine if patients with significant splenic mass loss receive recommended vaccinations.
• To compare immunization rates after splenic embolization to established guidelines.

Main Methods:

• Retrospective review of trauma patients undergoing splenic embolization (2010-2015) at a Level 1 trauma center.
• Collected data on demographics, injury severity, embolization extent, and immunization records.
• Assessed spleen embolization proportion using angiographic imaging.

Main Results:

• Nineteen patients met inclusion criteria; 15 had >50% splenic mass loss.
• Only 8 patients received any immunization before discharge; none received recommended boosters.
• Four patients with <50% splenic mass loss incorrectly received immunizations.

Conclusions:

• Trauma patients undergoing splenic embolization receive incorrect and incomplete immunizations.
• Lack of recommended vaccines and boosters poses a risk for infection.
• Standardizing immunization practices is crucial to improve care and reduce asplenia-related complications.