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Predicting venous thrombosis in patients undergoing elective splenectomy.
Peter Szasz1,2, Ali Ardestani3, Brent T Shoji4
1Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA. pszasz@bwh.harvard.edu.
Surgical Endoscopy
|July 31, 2019
Summary
Post-splenectomy platelet counts can predict venous thrombosis (VT) risk in patients. Identifying specific platelet count cutoffs can help personalize prophylactic strategies to prevent VT after splenectomy.
Area of Science:
- Surgical Oncology
- Hematology
- Thrombosis Research
Background:
- Venous thrombosis (VT) is a significant complication following elective splenectomy.
- Limited data exists on risk factors for VT in this patient population.
- Post-operative platelet elevation is common after splenectomy, but its role in VT risk is understudied.
Purpose of the Study:
- To determine the incidence of VT events after elective splenectomy.
- To evaluate post-operative platelet counts as a predictor for VT development.
Main Methods:
- Retrospective review of elective splenectomy patients (1997-2018).
- Descriptive statistics to calculate VT incidence.
- Receiver operator characteristic (ROC) curves to identify predictive platelet count thresholds.
Main Results:
- Overall VT incidence was 6.7% (35/520).
- Platelet counts were significant predictors of VT (AUC 0.77, p<0.001).
- Optimal platelet cutoffs identified: 545 (overall), 457 (open), 659 (laparoscopic), with high diagnostic accuracy and negative predictive value.
Conclusions:
- Established platelet count cutoffs can predict VT development post-splenectomy.
- This predictive information allows for individualized prophylactic strategies.
- Further research can refine risk stratification and prevention protocols.
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