The predictors of mortality in non-traumatic splenectomies

Küçük Resim Yok

Tarih

2020

Yazarlar

Dergi Başlığı

Dergi ISSN

Cilt Başlığı

Yayıncı

IBEPEGE - Inst. Bras. Estudos Pesquisas Gastroent.

Erişim Hakkı

info:eu-repo/semantics/openAccess

Özet

Background – There are quite a few studies examining prognostic factors in non-traumatic splenectomies compared to traumatic ones. Objective – This study aimed to evaluate the predictors of mortality in patients who underwent splenectomy for non-traumatic spleen diseases. Methods – Medical records of the patients, who had undergone total splenectomy for non-traumatic spleen diseases at a tertiary center between January 2009 and December 2019, were retrospectively reviewed. Exclusion criteria included patients younger than 18 years of age, partial splenectomies, splenectomies applied to facilitate surgery for malignancy on contiguous organs, and splenectomies performed during liver transplantation. Iatrogenic splenic injuries were regarded as trauma and these cases were also excluded. Results – The current study included 98 patients. Nine (9.2%) patients died. In univariate analysis, age, the presence of hematological neoplasia, hematocrit, hemoglobin, white blood cell counts, neutrophil-to-lymphocyte ratio, indications for splenectomy, application of emergency surgery, surgical technique, and transfusion of blood components were all significantly associated with mortality. In multivariate analysis, the presence of hematological malignancy [P=0.072; OR=7.17; (CI: 0.386–61.56)], the application of emergency surgery [P=0.035; OR=8.33; (CI: 1.165–59.595)] and leukocytosis [P=0.057; OR=1.136; (CI: 0.996–1.296)] were found to be positively associated with mortality. Conclusion – Hematologic neoplasia, emergency surgery, and leukocytosis were the independent predictors of mortality in patients, who were operated on for non-traumatic spleen diseases. A thorough preoperative evaluation, early therapeutic intervention, and advanced surgical techniques are important and can serve to minimize complications and mortality in case of inevitable splenectomy. Immunological research can provide new therapeutic opportunities that may impact positively on patients by minimizing morbidity and mortality. © 2020, IBEPEGE - Inst. Bras. Estudos Pesquisas Gastroent. All rights reserved.

Açıklama

Anahtar Kelimeler

Emergencies, Hematologic neoplasms, Leukocytosis, Risk factors, Splenectomy, mortality, Splenic diseases

Kaynak

Arquivos de Gastroenterologia

WoS Q Değeri

Scopus Q Değeri

Q3

Cilt

57

Sayı

4

Künye