Debora H Lee1, Galinos Barmparas2, Nicole Fierro3, Beatrice J Sun4, Sogol Ashrafian5, Tong Li6, Eric J Ley7. 1. Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: Debora.Lee@ucla.edu. 2. Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: gbarmparas@gmail.com. 3. Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: nfierro@ucla.edu. 4. Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: beatrice.sun@cshs.org. 5. Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: sogolashrafian@gmail.com. 6. Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: tong.li@ucla.edu. 7. Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: Eric.Ley@cshs.org.
Abstract
BACKGROUND: Thrombocytosis following splenectomy is a common occurrence. Whether this thrombocytosis leads to a higher risk for venous thromboembolism (VTE) remains unclear. This investigation aimed to determine if splenectomy increases the risk for VTE. METHODS: This was a prospective study conducted in the SICU between 1/2011 and 11/2013 investigating the VTE risk in patients undergoing a splenectomy compared with those undergoing any other abdominal procedure. RESULTS: In total 2503 patients were admitted to the SICU: 37 (2%) after a splenectomy and 638 (26%) after any other abdominal surgery. Splenectomy patients had a higher incidence of VTE compared to patients undergoing any other abdominal procedure (29.7% vs. 12.1%, p < 0.01). After adjustment, splenectomy was associated with a higher adjusted risk for VTE compared to the no-splenectomy group (AOR [95% CI]: 2.6 [1.2, 5.9], p = 0.02). Reactive thrombocytosis did not predict the development of VTE. CONCLUSION: Splenectomy increases the risk for VTE, however reactive thrombocytosis is not associated with this higher incidence. Further investigations are required to characterize the pathophysiologic mechanisms of VTE development following splenectomy.
BACKGROUND:Thrombocytosis following splenectomy is a common occurrence. Whether this thrombocytosis leads to a higher risk for venous thromboembolism (VTE) remains unclear. This investigation aimed to determine if splenectomy increases the risk for VTE. METHODS: This was a prospective study conducted in the SICU between 1/2011 and 11/2013 investigating the VTE risk in patients undergoing a splenectomy compared with those undergoing any other abdominal procedure. RESULTS: In total 2503 patients were admitted to the SICU: 37 (2%) after a splenectomy and 638 (26%) after any other abdominal surgery. Splenectomy patients had a higher incidence of VTE compared to patients undergoing any other abdominal procedure (29.7% vs. 12.1%, p < 0.01). After adjustment, splenectomy was associated with a higher adjusted risk for VTE compared to the no-splenectomy group (AOR [95% CI]: 2.6 [1.2, 5.9], p = 0.02). Reactive thrombocytosis did not predict the development of VTE. CONCLUSION: Splenectomy increases the risk for VTE, however reactive thrombocytosis is not associated with this higher incidence. Further investigations are required to characterize the pathophysiologic mechanisms of VTE development following splenectomy.