Moorjani et al evaluated patients undergoing nontraumatic splenectomy. They identified risk factors for perioperative mortality in these patients. The authors are from Hospital Universitario Gran Canaria Dr. Negrin in Spain.
Patient selection: nontraumatic splenectomy
Risk factors for perioperative mortality (Table 4):
(1) ASA classification III or higher
(2) blood transfusion
(3) pneumonia
(4) older age (mortality group 64.7 +/- 17.4; survivors 48.6 +/- 17.3; will use > 60 years in implementation)
Additional risk factors are leukocytosis and pleural effusions.
Only pneumonia had a p value less than 0.05 (0.024).
Immunosuppression may be a factor contributing to perioperative infection.
Immune thrombocytopenic purpura (ITP) was associated with fewer complications. Splenectomy for a malignant hematologic condition was associated with greater postoperative complications. Age may be a marker for hematologic malignancy.
A patient with risk factors may benefit from more aggressive management.
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