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November 12, 1982

Postsplenectomy Sepsis and Mortality in Adults

Author Affiliations

From the Departments of Surgery (Drs Schwartz, Sterioff, and Mucha) and Medical Statistics and Epidemiology (Dr Melton and Mr Offord), Mayo Clinic and Mayo Foundation, Rochester, Minn. Dr Schwartz is now with the Naval Regional Medical Center, San Diego.

JAMA. 1982;248(18):2279-2283. doi:10.1001/jama.1982.03330180039029

From 1955 to 1979, in Rochester, Minn, 193 residents with a mean age of 46 years underwent splenectomy. Only two cases of fulminant sepsis were documented during the 1,090 person-years of follow-up (0.18 cases per 100 person-years) in this unselected population. The incidence of any type of serious infection subsequent to splenectomy was estimated at 7.16 infections per 100 person-years of follow-up (78 cases). The incidence of infections was significantly increased among patients undergoing incidental splenectomy in conjunction with abdominal operations for malignant neoplasms or other conditions. Immunosuppression, radiation, and chemotherapy also significantly increased the risk of subsequent infection. The low risk of fulminant sepsis after splenectomy in the general adult population justifies a policy of individualization of each case as to the relative merits of splenectomy v splenic preservation.

(JAMA 1982;248:2279-2283)

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