Splenic volume on computed tomography scans is associated with mortality in patients with sepsis

The spleen is a key organ of the immune system. Asplenia has been reported to increase the risk of sepsis from overwhelming post-splenectomy infection. However, there are few reports on the association between splenic volume and mortality in patients with no history of splenectomy. This study focused on splenic volume of patients with sepsis and evaluated the association between splenic volume and mortality.

We retrospectively investigated 232 patients with sepsis. The splenic volume was calculated by using computed tomography scans obtained on admission. The patients were categorized into tertiles based on their splenic volume, and the relationship between splenic volume and mortality was evaluated. Odds ratio curves based on splenic volume were created to assess the continuous associations between splenic volume and outcome with a logistic regression model.

The patients with sepsis were divided into three groups according to the first (73.6cm³) and second (128.7cm³) tertile values of splenic volume. Kaplan-Meier estimation of the probability of the patients' survival followed up to 28 days showed significant differences between the groups (p=0.03). The hazard ratio for 28-day mortality in the first tertile group was 3.46 (95% CI 1.3-10.2; p=0.01) as compared with patients in the third tertile group. Patients with smaller spleens had increased odds ratios for mortality in the logistic regression model.

Splenic volume appeared to be an independent predictor of poor prognosis.