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Septic complications after splenectomy for sickle cell sequestration crisis
D L Sorrells1, T B Morrissey, M F Brown
1Department of Surgery, Louisiana State University Medical Center, Shreveport, USA.
Pediatric Surgery International
|May 1, 1998
Summary
Splenectomy in sickle cell disease (SCD) patients did not increase infectious complications or sepsis episodes. This study found no significant post-operative rise in infections, contrary to common concerns for SCD patients.
Area of Science:
- Pediatric Hematology
- Infectious Diseases
- Surgical Complications
Background:
- Patients with sickle cell disease (SCD) have an increased risk of infections.
- Recent data on post-splenectomy infectious complications in SCD patients is limited.
Purpose of the Study:
- To investigate whether splenectomy impacts the incidence of infectious complications in patients with sickle cell disease.
Main Methods:
- Retrospective chart review of 16 SCD patients who underwent splenectomy for sequestration crises between 1988-1992.
- Comparison of infectious parameters (admissions, hospital days, IV antibiotics, positive cultures, sepsis episodes) in pre- and post-splenectomy periods, calculated per year.
Main Results:
- No significant differences were observed in admissions, hospital days, IV antibiotic use, positive cultures, or sepsis episodes per year between pre- and post-splenectomy periods.
- The incidence of sepsis was 0.04 episodes/year pre-splenectomy versus 0.09 episodes/year post-splenectomy (not significant).
- Streptococcus pneumoniae was the most common organism causing sepsis, occurring at a mean of 20.8 months postoperatively.
Conclusions:
- Splenectomy does not appear to increase the risk of infectious complications or sepsis in patients with sickle cell disease.
- While infections are common in SCD, this study suggests splenectomy is not associated with a heightened infectious burden.