Predictors of infection response in trauma patients after splenectomy: Follow up study
Journal Title: Medpulse International Journal of Surgery - Year 2018, Vol 7, Issue 1
Abstract
Background: After splenectomy, patients may be vulnerable for post-operative infections due to multiple causes. Objective: To assess the three risk factors i.e. total count, platelet count / total count ratio and Injury Severity Score (ISS) for post-operative infection in patients undergoing splenectomy as a result of splenic injuries and to assess whether these factors can predict the occurrence of infection after splenectomy. Materials and Methods: This is a follow up (prospective) study on trauma patients who underwent splenectomy at a tertiary care teaching hospital in Chennai, Tamil Nadu. Total count and platelet counts were done on daily basis for all the patients usually till tenth day from surgery. Severity of the injury was assessed using Injury Severity Score (ISS). Results: There were a total of 50 trauma patients who underwent splenectomy during the study period. Of total 50 patients, 18 (36%) developed post-operative infection. The mean (SD) ISS among patients with post-operative infection was significantly lower compared to patients without post-operative infection [20.9 (6.0) vs 15.3 (4.2); p value<0.001]. Mean (SD) of total WBC count, platelet count and platelet count/total count ratio at day five in post-operative infective patients significantly differed from non-infective patients. Presence of two or more risk factors (TC>15000 on post-operative day 5, PC/TC ratio >20 on post-operative day 5, and ISS >16) was reported in 19 patients; of whom 15 (78.9%) had infection. Conclusion: Infectious complications are common after splenectomy and absence of the trio of risk factors reliably rules out postoperative infection.
Authors and Affiliations
Bharathidhasan Vijayaraman, Sivabalan Palanidurai
Keywords
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