Risk of infection and death among post-splenectomy patients

Objectives: The true incidence of post-splenectomy sepsis remains undetermi ned. Methods: An English literature review on post-splenectomy sepsis was undert aken by means of databases of MEDLINE for the period 1966-96. The data regi stered included age at splenectomy, indication for splenectomy, incidence o f infection and death, interval between splenectomy and infection, and micr obial aetiology. Results: The reports include 19 680 patients having undergone splenectomy w ith a median follow up of 6.9 years. The incidence of infection after splen ectomy was 3.2% and the mortality rate was 1.4%. Only 6942 reports were suf ficiently detailed to allow useful analysis. The incidence of infection amo ng children and adults was similar, 3.3% and 3.2%. respectively. However, t he death rates among children were higher than adults (1.7% vs. 1.3%). The incidence of infection was highest among patients with thalassemia major (8 .2%), and sickle-cell anaemia (7.3%). The highest mortality rates were obse rved among patients with thalassaemia major (5.1%), and sickle-cell anaemia (4.8%). Conclusion: The incidence of sepsis among post-splenectomy patients is low, however, it carries a high mortality rate especially among children with h ematological disorders. (C) 2001 The British Infection Society.