Background: Children who have undergone splenectomy may develop impaired immunologic function and heightened risk of overwhelming postsplenectomy infection. We sought to define the long-term rate of and risk factors for postsplenectomy sepsis.

Methods: We leveraged the Military Health System Data Repository, a nationally representative claims database including >3 million children registered as dependents of members of the United States Armed Services (2005-2014). Inclusion criterion was splenectomy at age 18 years or prior. The primary outcome was hospitalization for sepsis.

Results: Among 195 children who underwent splenectomy, 7% (n = 13) were hospitalized with sepsis, with an incidence of 1.8 (95% CI = 1.0-3.1) events per 100 person-years. The median time to sepsis was 224 days (IQR = 109-606) and 38% (5/13) of events occurred within the first postsplenectomy year. The postsplenectomy mortality rate was 1% (n = 3). After adjusting for underlying diagnosis, older age at splenectomy (HR = 0.90 per year, 95% CI = 0.81-0.99) was associated with decreased hazard of sepsis.

Conclusions: In a contemporary national cohort, the prevalence of postsplenectomy sepsis was 7% (1.8 events per 100 person-years). Although most presented during the first year after splenectomy, many (62%) sepsis events occurred later, suggesting that postsplenectomy immunologic dysfunction persists beyond one year. The immunologic consequences of asplenia must continue to be acknowledged, as postsplenectomy sepsis remains a serious concern.

Type Of Study: Prognosis study.

Level Of Evidence: Level III.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jpedsurg.2018.06.024DOI Listing

Publication Analysis

Top Keywords

risk factors
8
events 100
8
100 person-years
8
events occurred
8
postsplenectomy sepsis
8
sepsis events
8
postsplenectomy
7
sepsis
6
splenectomy
6
incidence risk
4

Similar Publications

Aim: Breast cancer is the second most common cancer among women and the leading cause of cancer-related mortality in this population. Numerous factors have been identified as either risk factors or protective factors for breast cancer. However, the role of Vitamin D (Vit.

View Article and Find Full Text PDF

Introduction: Hospital-based violence intervention programs primarily target adults, raising questions about the effectiveness in preventing pediatric firearm deaths. We hypothesized that pediatric and adult firearm injury deaths are different enough to require unique intervention strategies.

Methods: Retrospective chart review was conducted of medical examiner and trauma center records of firearm-related deaths in the largest metropolitan county in Texas.

View Article and Find Full Text PDF

Background: A number of efforts have been made to tailor behavioral healthcare treatments to the variable needs of patients with low back pain (LBP). The most common approach involves the STarT Back Screening Tool (SBST) to triage the need for psychologically informed care, which explores concerns about pain and addresses unhelpful beliefs, attitudes, and behaviors. Such beliefs that pain always signifies injury or tissue damage and that exercise should be avoided have been implied as psychosocial mediators of chronic pain and can impede recovery.

View Article and Find Full Text PDF

Adherence to Oral Anticancer Agents Among Adults With Gastrointestinal Tract Cancer: A Scoping Review.

Cancer Nurs

January 2025

Author Affiliations: The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Shatin, Hong Kong (Ms Chen and Drs Ng, Zhang, and Chan); and Nursing Department, People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China (Ms Chen).

Background: Patients with gastrointestinal tract cancer reported suboptimal adherence to oral anticancer agents (OAAs), reducing their therapeutic benefit and increasing mortality risk. A scoping review can comprehensively map available evidence on adherence to OAAs and inform appropriate support to improve treatment outcomes.

Objective: The aim of this study was to comprehensively map studies on adherence to OAAs among adults with gastrointestinal tract cancer, including the adherence rate, nonadherence reasons, influential factors, management strategies, and theories that guide these studies.

View Article and Find Full Text PDF

Background: Nonweightbearing preoperative assessments avoid quadriceps contraction that tends to affect patellar motion and appear to be inaccurate in quantifying anatomic factors, which can lead to incorrect corrections and postoperative complications.

Questions/purposes: (1) Does the relationship of patellar axial malalignment and other anatomic factors change during weightbearing? (2) What anatomic factor was most strongly correlated with recurrent patellar dislocation during weightbearing?

Methods: This prospective, comparative, observational study recruited participants at our institution between January 2023 and September 2023. During this time, all patients with recurrent patellar dislocations received both weightbearing and nonweightbearing CT scans; control patients who received unilateral CT scans because of injuries or benign tumors received both weightbearing and nonweightbearing CT scans.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!