impact of splenectomy on the patient's susceptability to infection

ABSTRACT

Splenectomy, is a procedure that has significantly decreased in frequency as the understanding of its complications increase. Susceptibility to infection is the best-defined and most widely understood complication of splenectomy. The aim was to study the impact of splenectomy on the patients susceptibility to infections, and its effect on morbidity and mortality statistics of patients admitted to fever hospitals. The study included 506 patients admitted to fever hospital and they divided according to history of splenectomy into group 1 of 432 patients with no history of splenectomy and group II of 74 patients with history of splenectomy. The cause and duration of splenectomy, hospital stay, the type and duration of antibiotic prescribed in hospital the diagnosis and the outcome at discharge were the main history items. Chronic liver disease [CLD] was the main cause of splenectomy followed by trauma and Thalassemia 67%, 20% and 12% respectively. No significant difference in blood culture between the 2 group but capsulated organism were more in group II. Respiratory tract infection was the main cause of admission in both groups with a high incidence of respiratory, urinary tract infection, meningitis and pyrexia of unknown origin in group II. Quinolones, Penicillin and Cephalosporins were the commonly used groups of antibiotics with statistical difference in group 2 than group 1. Prolonged hospital stay in group II with high statistical difference than group I [14.07 +/- 8.68 versus 4.57 +/- 3.29] [P<0.001]. The improved outcome were significantly higher in group 1 than group 2 and the not improved outcome [frequent admission, escape from hospital and university hospital referral] were higher in group 2 than group 1 and it correlate with duration of splenectomy