Underlying disease is the main risk factor in post‐splenectomy complication risk: Data from a national database

Splenectomy is required for many haematological conditions and causes an increased risk of severe infections and vascular events. The association between underlying haematological disease, age at splenectomy and post-splenectomy complications was explored among 1348 splenectomized patients, followed with a median follow-up time of 13 years and affected by transfusion-dependent thalassaemia, non-transfusion-dependent thalassaemia (NTDT), sickle cell anaemia (SCA), congenital haemolytic anaemias, autoimmune haematological disorders and trauma. Our main statistical approach was based on interaction analyses within competing-risk survival models. The baseline risk profile differed across diagnostic categories, with SCA being particularly susceptible to infectious complications and NTDT and SCA to vascular events (p < 0.001). The age at splenectomy did not impact on infectious risk but rather older age at splenectomy was associated with increased risk for vascular complications. Furthermore, the risk of developing a post-splenectomy complication was persistent throughout the observation period and not limited to the first 2-3 years after splenectomy. The probability of a post-splenectomy complication was highly dependent on the underlying disease and not on the age at splenectomy, so the indications for splenectomy must be based on careful assessment of pros and cons in the individual disease, with no need to delay surgery after a certain age when clinically indicated.

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Publication Details

Journal
British Journal of Haematology
Published
2025-04-29
DOI
https://doi.org/10.1111/bjh.20114
Citations
2
Primary Topic
Abdominal Trauma and Injuries
Type
article
Field-Weighted Citation Impact
4.01

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article

Underlying disease is the main risk factor in post‐splenectomy complication risk: Data from a national database

Maria Caterina Putti, Saverio Ladogana, Saveria Campisi, Fiorina Giona et al.
2 citations
British Journal of Haematology
Abdominal Trauma and Injuries
4.01
article

Underlying disease is the main risk factor in post‐splenectomy complication risk: Data from a national database

Maria Caterina Putti, Saverio Ladogana, Saveria Campisi, Fiorina Giona, Simone Ferrero, Pellegrina Pugliese, L. Farinasso, Simone Cesaro, Tommaso Casini, Domenico Roberti, Carlo Baronci, Maddalena Casale, Silverio Perrotta, Tommaso Mina, Gianluca Boscarol, Marzia Manilia, Antonio Ivan Lazzarino, Susanna Barella, Gian Luca Forni, Manuela Balocco, Antonella Sau, Lucia Dora Notarangelo, Elena Facchini, Giovanna Graziadei, Raffaella Colombatti, Giovanna Russo, Paola Corti, Ilaria Lazzareschi, Giovanni Palazzi, Marilena Serra
article en
2 citations

Abstract

Splenectomy is required for many haematological conditions and causes an increased risk of severe infections and vascular events. The association between underlying haematological disease, age at splenectomy and post-splenectomy complications was explored among 1348 splenectomized patients, followed with a median follow-up time of 13 years and affected by transfusion-dependent thalassaemia, non-transfusion-dependent thalassaemia (NTDT), sickle cell anaemia (SCA), congenital haemolytic anaemias, autoimmune haematological disorders and trauma. Our main statistical approach was based on interaction analyses within competing-risk survival models. The baseline risk profile differed across diagnostic categories, with SCA being particularly susceptible to infectious complications and NTDT and SCA to vascular events (p < 0.001). The age at splenectomy did not impact on infectious risk but rather older age at splenectomy was associated with increased risk for vascular complications. Furthermore, the risk of developing a post-splenectomy complication was persistent throughout the observation period and not limited to the first 2-3 years after splenectomy. The probability of a post-splenectomy complication was highly dependent on the underlying disease and not on the age at splenectomy, so the indications for splenectomy must be based on careful assessment of pros and cons in the individual disease, with no need to delay surgery after a certain age when clinically indicated.

British Journal of HaematologyVol. 206(6)
University of Padua (IT), University of Campania "Luigi Vanvitelli" (IT), Casa Sollievo della Sofferenza (IT), Policlinico Umberto I (IT), Agostino Gemelli University Polyclinic (IT), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Ente Ospedaliero Ospedali Galliera (IT), University of Catania (IT), Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT), Ospedale Maggiore (IT), Ospedale di Bolzano (IT), Azienda Ospedaliera Universitaria Integrata Verona (IT), Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT), Ospedale di Santo Spirito (IT), Azienda Ospedaliero-Universitaria di Modena (IT), Meyer Children's Hospital (IT), Bambino Gesù Children's Hospital (IT), Ospedale Microcitemico (IT), Policlinico Universitario di Catania (IT), Ospedale Vito Fazzi (IT), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Ospedali Riuniti Umberto I (IT), University of Turin (IT), Sapienza University of Rome (IT)
American Society of Hematology
Good health and well-being
Openalex Percentile: Top 8%
Abdominal Trauma and Injuries
4.01
DOIOpen Access PDFOpenAlex
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