Postsplenectomy sepsis and mortality in adults

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Abstract
From 1955-1979, in Rochester, Minnesota, USA, 193 residents with a mean age of 46 yr underwent splenectomy. Only 2 cases of fulminant sepsis were documented during the 1090 person-years of follow-up (0.18 cases/100 person-years) in this unselected population. The incidence of any type of serious infection subsequent to splenectomy was estimated at 7.16 infections/100 person-years of follow-up (78 cases). The incidence of infections was significantly increased among patients undergoing incidental splenectomy in conjunction with abdominal operations for malignant neoplasms or other conditions. Immunosuppression, radiation and chemotherapy also significantly increased the risk of subsequent infection. The low risk of fulminant sepsis after splenectomy in the general adult population justifies a policy of individualization of each case as to the relative merits of splenectomy vs. splenic preservation.