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Evaluation of the risk factors for venous thromboembolism post splenectomy – A ten year retrospective cohort study in St James’s hospital

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Show simple item record Abduljalil, Manal Saunders, Jean Doherty, Dearbhla Dicks, Marthinus Maher, Catherine Mehigan, Brian Flavin, Richard Flynn, Catherine M. 2021-07-06T14:08:20Z 2021-07-06T14:08:20Z 2021
dc.description peer-reviewed en_US
dc.description.abstract ackground: Splenectomy is a surgical intervention for a variety of indications; benign and malignant. Compli cations of this procedure include Venous thromboembolism (VTE) and infection. The incidence of VTE post surgery has been reported between 0.8%–3% depending on the type of surgery. A higher incidence of abdom inal VTE was reported post splenectomy (6–11%). However, there is limited literature regarding the risk factors for post splenectomy VTE and the optimal strategy for thromboprophylaxis. Objective: The primary objective of the study was to evaluate the incidence of VTE post splenectomy and to identify the pre-operative, intra-operative and post-operative risk factors. The secondary objective was to assess the local compliance with post-splenectomy prophylactic antibiotics and vaccination protocols. Methods: We conducted a retrospective observational study. All patients who had a splenectomy in St James’s Hospital between January 2007 and June 2017 were included and reviewed. Statistical analysis was carried out using SPSS statistical package. Results: 85 patients were involved in the study. The main indications for splenectomy were benign haematology, malignant haematology, solid tumours, traumatic and spontaneous rupture. 6/85 patients developed VTE (7.06%). High BMI ≥ 30 was associated with increased risk of VTE (p = 0.007), while the use of post-operative pro phylactic anticoagulation was associated with reduced risk (p = 0.005). Other factors including age >50 years, female gender, presence of active malignancy and splenomegaly were associated with increased VTE risk with no statistical significance. All VTE’s occurred in elective versus emergency splenectomy. Laparoscopic splenectomy was associated with higher risk of VTE than open splenectomy. 97% of patients were prescribed prophylactic antibiotics on discharge, but only 88% had received recommended vaccinations. Conclusion: Venous thromboembolism is common post splenectomy. Our data showed that BMI ≥30 was asso ciated with a statistically significant increased risk of VTE, while the use of prophylactic anticoagulation was associated with reduced risk. Further prospective studies with larger samples are warranted and a splenectomy care plan may be helpful. en_US
dc.language.iso eng en_US
dc.publisher Elsevier en_US
dc.relation.ispartofseries Annals of Medicine and Surgery;66, 102381
dc.subject splenectomy en_US
dc.subject venous thromboembolism en_US
dc.subject obesity en_US
dc.subject prophylactic anticoagulation en_US
dc.title Evaluation of the risk factors for venous thromboembolism post splenectomy – A ten year retrospective cohort study in St James’s hospital en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.identifier.doi 10.1016/j.amsu.2021.102381
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US

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