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Ishak AR, Hsieh YC, Srinivasan H, See KC. Review of Vaccination Recommendations in Guidelines for Non-Communicable Diseases with Highest Global Disease Burden among Adults 75 Years Old and Above. Vaccines (Basel) 2023; 11:1076. [PMID: 37376465 DOI: 10.3390/vaccines11061076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/31/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
This scientific review paper explores international and country-specific healthcare guidelines for non-communicable diseases with the highest burden among individuals aged 75 years and above. The study aims to identify the best vaccination practices and standardize healthcare practices to improve vaccination adherence in this vulnerable population. Given that older people are more prone to infectious illnesses and have higher rates of morbidity and mortality, vaccinations are essential for disease prevention. Despite the proven efficacy of vaccinations, adherence has plateaued in recent years, partly due to a lack of accessibility, public education, and variability in disease-specific guidelines. This paper highlights the need for a more robust and standardized international vaccination model to improve quality of life and reduce disability-adjusted life years among the elderly. The findings of this study call for further research to review the guidelines as more implementations are put in place, including non-English guidelines.
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Affiliation(s)
- Abdul Rahman Ishak
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Yu Chun Hsieh
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Harshitha Srinivasan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Kay Choong See
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
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Szempruch KR, Walter K, Ebert N, Bridgens K, Desai CS. Pharmacological management of patients undergoing total pancreatectomy with auto-islet transplantation. Pancreatology 2022; 22:656-664. [PMID: 35490122 DOI: 10.1016/j.pan.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/17/2022] [Accepted: 04/15/2022] [Indexed: 12/11/2022]
Abstract
Chronic pancreatitis results in permanent parenchymal destruction of the pancreas gland leading to anatomical and physiological consequences for patients. Surgical management varies, and some patients require total pancreatectomy with autologous islet cell transplantation (TPIAT). Patients undergoing TPIAT require complex and diligent management after surgery. This encompasses the management of glucose control (endocrine function of the pancreas) and supplementing loss of exocrine function of the pancreas with digestive enzymes. Other areas of management include optimizing pain relief while reducing narcotic usage, providing antimicrobial prophylaxis, and reducing loss of islet cells by improving its integrity through anticoagulation and use of anti-inflammatory agents. Each aspect of care is unique to this population. However, comprehensive reviews on its pharmacological management are scarce. This review will discuss the available literature to date surrounding all aspects of pharmacological management of patients undergoing TPIAT.
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Affiliation(s)
- Kristen R Szempruch
- Pharmacy Department, University of North Carolina Medical Center, Chapel Hill, NC, USA
| | - Krysta Walter
- Pharmacy Department, Michigan Medicine, Ann Arbor, MI, USA
| | - Natassha Ebert
- Pharmacy Department, University of North Carolina Medical Center, Chapel Hill, NC, USA
| | - Kathryn Bridgens
- Department of Nutrition and Food Services, University of North Carolina Medical Center, Chapel Hill, NC, USA
| | - Chirag S Desai
- Department of Surgery, Transplant, University of North Carolina Medical Center, Chapel Hill, NC, USA.
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Camejo L, Nandeesha N, Phan K, Chharath K, Tran T, Ciesla D, Velanovich V. Infectious outcomes after splenectomy for trauma, splenectomy for disease and splenectomy with distal pancreatectomy. Langenbecks Arch Surg 2022; 407:1685-1691. [PMID: 35075620 PMCID: PMC8786199 DOI: 10.1007/s00423-022-02446-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/15/2022] [Indexed: 12/01/2022]
Abstract
Introduction The spleen provides a unique immune function in its production of opsins directed against encapsulated bacteria. Splenectomy, therefore, increases the risk of infections in patients as well as post-operative complications. This study aims to assess the risk of post-operative complications within 5 years of splenectomy by indication for splenectomy: trauma, disease, or in association with a distal pancreatectomy for pancreatic disease. The relationship between vaccination and infectious outcomes was also investigated. Methods This study is a review of splenectomy cases between June 2005 and June 2015 at a single institution. Infection, splenectomy indication, and vaccination history were identified from electronic medical records and lab test confirmations. Data was analyzed using Student’s t test for continuous variables, the Mann–Whitney U test for ordinal variables, and a Chi-square/Fisher exact test for categorical variables. Results A total of 106 splenectomy patients were included: 35 traumatic (74% male) and 71 non-traumatic causes (42% male) with no significant difference in age. There were no statistical differences in complications during splenectomy and vaccination administration between the splenectomy indication groups: trauma, disease, and with distal pancreatectomy. There was a statistically significant higher infection rate within 5 years post-splenectomy in the non-traumatic vs traumatic group (42% vs 14.0%, p = 0.0040) with majority gastrointestinal (7/38) and respiratory (5/38) and surgical wound infections (3/38) observed in non-traumatic versus traumatic, respectively. Conclusion Results from data analysis show a statistically significant difference in rates of infection within 5 years post-operatively between traumatic versus non-traumatic indications for splenectomies, with the non-traumatic group experiencing a higher rate of infectious outcomes. The non-traumatic group included patients with disease and distal pancreatectomy indications. This suggests that patients who have non-traumatic causes may be at a higher risk of developing infections following splenectomy procedure. Additionally, vaccinations did not appear to have a protective effect.
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Affiliation(s)
- Leonel Camejo
- Department of Surgery, Division of Gastrointestinal Surgery, Morsani College of Medicine, University of South Florida, 5 Tampa General Circle, Suite 740, Tampa, FL, 33606, USA
| | - Nandini Nandeesha
- Department of Surgery, Division of Gastrointestinal Surgery, Morsani College of Medicine, University of South Florida, 5 Tampa General Circle, Suite 740, Tampa, FL, 33606, USA
| | - Kevin Phan
- Department of Surgery, Division of Gastrointestinal Surgery, Morsani College of Medicine, University of South Florida, 5 Tampa General Circle, Suite 740, Tampa, FL, 33606, USA
| | - Khattiya Chharath
- Department of Surgery, Division of Gastrointestinal Surgery, Morsani College of Medicine, University of South Florida, 5 Tampa General Circle, Suite 740, Tampa, FL, 33606, USA
| | - Thanh Tran
- Department of Surgery, Division of Gastrointestinal Surgery, Morsani College of Medicine, University of South Florida, 5 Tampa General Circle, Suite 740, Tampa, FL, 33606, USA
| | - David Ciesla
- Department of Surgery, Division of Gastrointestinal Surgery, Morsani College of Medicine, University of South Florida, 5 Tampa General Circle, Suite 740, Tampa, FL, 33606, USA
| | - Vic Velanovich
- Department of Surgery, Division of Gastrointestinal Surgery, Morsani College of Medicine, University of South Florida, 5 Tampa General Circle, Suite 740, Tampa, FL, 33606, USA.
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Bianchi FP, Stefanizzi P, Spinelli G, Mascipinto S, Tafuri S. Immunization coverage among asplenic patients and strategies to increase vaccination compliance: a systematic review and meta-analysis. Expert Rev Vaccines 2021; 20:297-308. [PMID: 33538617 DOI: 10.1080/14760584.2021.1886085] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Asplenic or splenectomized patients have a higher risk (ranging from 10 to 50-fold) than the general population of developing an overwhelming post-splenectomy infection (OPSI). Thus, they should receive specific vaccinations to prevent bacterial infections and influenza. The aim of this meta-analysis was to estimate vaccination coverage (VC) with the recommended vaccines among splenectomized patients; strategies recommended in those studies to improve VC worldwide are considered as well. RESEARCH DESIGN AND METHODS Scopus, MEDLINE/PubMed, Google Scholar and ISI Web of Knowledge databases were searched. Research papers, short reports, reviews, and meta-analyses published between January 1, 2010 and July 18, 2020 were included; no geographic restrictions were included. Twenty-four studies were included in the meta-analysis. RESULTS For anti-pneumococcal vaccination, coverage was 55.1% (95%CI = 41.0-69.2%), for anti-Hib 48.3% (95%CI = 34.3-52.3%), for anti-meningococcal C/ACYW135 33.7% (95%CI = 23.6-43.9%), for anti-meningococcal B 13.3% (95%CI = 7.0-19.5%) and for anti-influenza 53.2% (95%CI = 22.0-84.4%). Most studies determined a lack of adherence to international guidelines by healthcare workers and suggested the need to better educate health professionals in the management of post-splenectomy patients. CONCLUSIONS The meta-analysis showed the suboptimal immunization coverage for the vaccines recommended for asplenic patients. Greater efforts must be made by public health professionals to increase VC in this group of patients at risk. Introducing specific prophylaxis protocols in the clinical routine seems to guarantee better immunization compliance in those patients.
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Affiliation(s)
- Francesco Paolo Bianchi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Giuseppe Spinelli
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Simona Mascipinto
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
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5
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Pozdeyev N, Patel A, Pottinger PS, Leu M, Payne TH. Adherence to Recommended Post-Splenectomy Immunizations to Reduce the Risk of Sepsis: The University of Washington Experience. Am J Med Qual 2020; 35:405-410. [DOI: 10.1177/1062860619897289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Immunizations against Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b are recommended for patients undergoing splenectomy to decrease the risk of developing overwhelming infections. The authors sought to determine adherence to these recommendations by providers at UW Medicine. Regional immunization records for patients who underwent splenectomy between October 2015 and January 2019 were analyzed to measure compliance with immunization guidelines from the US Centers for Disease Control and Prevention (CDC). Among 253 patients who underwent splenectomy, 38 (15%) received all 7 immunizations against S pneumoniae, N meningitidis, and H influenzae type b recommended by the CDC; 95% of patients received at least 1 pneumococcal vaccine; 26% percent of patients did not receive MenB-4C vaccine. Many patients (3% to 10%) received redundant immunizations not in accordance with CDC recommendations. Development of state and national immunization registries and systems to improve adherence with post-splenectomy immunization guidelines may reduce risk for life-threatening infections.
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Rieger CT, Liss B, Mellinghoff S, Buchheidt D, Cornely OA, Egerer G, Heinz WJ, Hentrich M, Maschmeyer G, Mayer K, Sandherr M, Silling G, Ullmann A, Vehreschild MJGT, von Lilienfeld-Toal M, Wolf HH, Lehners N. Anti-infective vaccination strategies in patients with hematologic malignancies or solid tumors-Guideline of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO). Ann Oncol 2019; 29:1354-1365. [PMID: 29688266 PMCID: PMC6005139 DOI: 10.1093/annonc/mdy117] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Infectious complications are a significant cause of morbidity and mortality in patients with malignancies specifically when receiving anticancer treatments. Prevention of infection through vaccines is an important aspect of clinical care of cancer patients. Immunocompromising effects of the underlying disease as well as of antineoplastic therapies need to be considered when devising vaccination strategies. This guideline provides clinical recommendations on vaccine use in cancer patients including autologous stem cell transplant recipients, while allogeneic stem cell transplantation is subject of a separate guideline. The document was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO) by reviewing currently available data and applying evidence-based medicine criteria.
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Affiliation(s)
- C T Rieger
- Hematology and Oncology Germering, Lehrpraxis der Ludwig-Maximilians-Universität, University of Munich, Munich.
| | - B Liss
- Department of Internal Medicine, Helios University Hospital Wuppertal, Wuppertal
| | - S Mellinghoff
- Department I of Internal Medicine, University Hospital Cologne, Cologne; CECAD Cluster of Excellence, University of Cologne, Cologne
| | - D Buchheidt
- Department of Internal Medicine - Hematology and Oncology, Mannheim University Hospital, University of Heidelberg, Heidelberg
| | - O A Cornely
- Department I of Internal Medicine, University Hospital Cologne, Cologne; CECAD Cluster of Excellence, University of Cologne, Cologne; Clinical Trials Center Cologne, ZKS Köln, University Hospital of Cologne, Cologne
| | - G Egerer
- Department of Hematology, University Hospital Heidelberg, Heidelberg
| | - W J Heinz
- Department of Internal Medicine II - Hematology and Oncology, University of Würzburg, Würzburg
| | - M Hentrich
- Department of Hematology and Oncology, Rotkreuzklinikum München, Munich
| | - G Maschmeyer
- Department of Hematology, Oncology and Palliative Care, Klinikum Ernst von Bergmann, Potsdam
| | - K Mayer
- Department of Hematology and Oncology, University Hospital Bonn, Bonn
| | | | - G Silling
- Department of Hematology and Oncology, University of Aachen, Aachen
| | - A Ullmann
- Department of Internal Medicine II - Hematology and Oncology, University of Würzburg, Würzburg
| | - M J G T Vehreschild
- Department of Internal Medicine, Helios University Hospital Wuppertal, Wuppertal
| | - M von Lilienfeld-Toal
- Department of Hematology and Oncology, Internal Medicine II, University Hospital Jena, Jena
| | - H H Wolf
- Department of Hematology and Oncology, University Hospital Halle, Halle
| | - N Lehners
- Department of Hematology, University Hospital Heidelberg, Heidelberg; Max-Eder-Group Experimental Therapies for Hematologic Malignancies, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Splenic Trauma during Colonoscopy: The Role of Intra-Abdominal Adhesions. Case Rep Gastrointest Med 2018; 2018:4879413. [PMID: 29862094 PMCID: PMC5976928 DOI: 10.1155/2018/4879413] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 02/19/2018] [Accepted: 04/16/2018] [Indexed: 12/27/2022] Open
Abstract
Splenic rupture following colonoscopy is rare, first reported in 1974, with incidence of 1–21/100,000. It is critical to anticipate splenic trauma during colonoscopy as one of the causes of abdominal pain after colonoscopy especially when located in the left upper quadrant or left shoulder. Postoperative adhesions is a predisposing factor for splenic injury, and management is either operative or nonoperative, based on hemodynamic stability and/or extravasation which can be seen on contrast-enhanced CT scan of the abdomen. We present a case of a splenic rupture after colonoscopy in a patient with splenocolic adhesions, requiring splenectomy as definite treatment.
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Ohkoshi Y, Sato T, Wada T, Fukushima Y, Murabayashi H, Takakuwa Y, Nishiyama K, Honda H, Shiraishi T, Kuronuma K, Takahashi H, Nakajima C, Suzuki Y, Yokota SI. Whole genome analysis of a multidrug-resistant Streptococcus pneumoniae isolate from a patient with invasive pneumococcal infection developing disseminated intravascular coagulation. J Infect Chemother 2018; 24:674-681. [PMID: 29496334 DOI: 10.1016/j.jiac.2018.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 01/15/2018] [Accepted: 01/20/2018] [Indexed: 01/03/2023]
Abstract
Multidrug-resistant Streptococcus pneumoniae strains were isolated from blood and sputum of a patient with disseminated intravascular coagulation in Sapporo city, Japan. These antibiograms were only susceptible to vancomycin, linezolid, daptomycin, some carbapenems, and some fluoroquinolones. Identical antibiograms, serotypes (19F), and sequence types (ST10017) suggested a shared origin of these isolates. Only one ST10017 strain has been isolated in the same city in Japan previously (2014), and the 2014 isolate is still susceptible to macrolides. The whole genome of the blood-derived isolate was sequenced. The strain harbored resistance mutations in parC, gyrA, pbp1a, pbp2a, pbp2b, and pbp2x, and harbored the resistance genes, ermB and tetM. The nucleotide sequences of parC and pbp2x genes of strain MDRSPN001 were clearly different from those of other S. pneumoniae strains and were similar to those of oral streptococci strains. These findings suggest that strain MDRSPN001 has been rapidly and drastically evolving multidrug resistance by gene replacement and accumulation of genes originating from other strains, such as oral streptococci, Streptococcus mitis.
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Affiliation(s)
- Yasuo Ohkoshi
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan; Department of Clinical Laboratory, NTT East Sapporo Hospital, Sapporo, Japan
| | - Toyotaka Sato
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takayuki Wada
- Department of International Health, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Yukari Fukushima
- Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan
| | - Hiromi Murabayashi
- Department of Clinical Laboratory, NTT East Sapporo Hospital, Sapporo, Japan
| | - Yasunari Takakuwa
- Department of Clinical Laboratory, NTT East Sapporo Hospital, Sapporo, Japan
| | - Kaoru Nishiyama
- Department of Respiratory Medicine, NTT East Sapporo Hospital, Sapporo, Japan
| | - Hiroyuki Honda
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan; Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Tsukasa Shiraishi
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Koji Kuronuma
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hiroki Takahashi
- Department of Respiratory Medicine and Allergology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Chie Nakajima
- Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan; Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan
| | - Yasuhiko Suzuki
- Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan; Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan
| | - Shin-Ichi Yokota
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan.
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Active offer of vaccinations during hospitalization improves coverage among splenectomized patients: An Italian experience. Am J Infect Control 2017; 45:e87-e89. [PMID: 28410825 DOI: 10.1016/j.ajic.2017.02.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 02/22/2017] [Accepted: 02/22/2017] [Indexed: 01/14/2023]
Abstract
In 2014, an Italian hospital implemented a protocol for pneumococcal, meningococcal, and Haemophilus influenzae type b vaccines offer to splenectomized patients during their hospitalization. After 1 year, coverage for recommended vaccinations increased from 5.7%-66.7% and the average time between splenectomy and vaccines administration decreased from 84.7-7.5 days.
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Carrico RM, Goss L, Wojcik J, Broughton-Miller K, Pentecost K, Frisbie M, Kotey S, Niyongabo D, Benns M, Raghuram A, Logsdon MC. Postsplenectomy vaccination guideline adherence: Opportunities for improvement. J Am Assoc Nurse Pract 2017; 29:612-617. [PMID: 28722321 DOI: 10.1002/2327-6924.12495] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 05/26/2017] [Accepted: 06/17/2017] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND PURPOSE Patients undergoing splenectomy for trauma are at life-long risk for rapidly progressive septicemia. The purpose of this study was to investigate long-term patient understanding and follow-up with recommendations regarding their asplenia. METHODS Patients undergoing splenectomy for trauma January 2010-December 2014 were analyzed. Medical records were reviewed and telephone follow-up interviews were conducted in October-December 2015. Patients were asked a standard set of questions that included hospitalizations, awareness of infectious risks associated with asplenia, need for revaccination, and vaccines they had received since their index hospitalization. FINDINGS Two hundred forty-four patients underwent splenectomy during the study period. A total of 95 patients (39%) were included in the study. Thirty (32%) had been hospitalized since their trauma admission. Only 46% were aware of the risks for sepsis and the need to revaccinate. Only 7% reported having rapid access to antibiotics. CONCLUSIONS Despite uniform education prior to discharge, most patients undergoing splenectomy for trauma were unaware of the risks for sepsis and did not follow recommended guidelines for risk reduction. IMPLICATIONS FOR PRACTICE Improvements that have direct implications for advanced practice included the need to refer for vaccination, educate regarding infection risks, and facilitate rapid access to antibiotic treatment.
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Affiliation(s)
- Ruth M Carrico
- University of Louisville Global Health Program, Division of Infectious Diseases, University of Louisville School of Medicine, Louisville, Kentucky
| | - Linda Goss
- University of Louisville Global Health Program, Division of Infectious Diseases, University of Louisville School of Medicine, Louisville, Kentucky
| | - Jodi Wojcik
- University of Louisville Hospital, Louisville, Kentucky
| | | | | | | | - Stanley Kotey
- University of Louisville Global Health Program, Division of Infectious Diseases, University of Louisville School of Medicine, Louisville, Kentucky
| | - Deborah Niyongabo
- University of Louisville Global Health Program, Division of Infectious Diseases, University of Louisville School of Medicine, Louisville, Kentucky
| | - Matthew Benns
- Department of Surgery, University of Louisville School of Medicine, University of Louisville, Louisville, Kentucky
| | - Anupama Raghuram
- University of Louisville Global Health Program, Division of Infectious Diseases, University of Louisville School of Medicine, Louisville, Kentucky
| | - M Cynthia Logsdon
- University of Louisville Hospital, Louisville, Kentucky.,School of Nursing, University of Louisville, Louisville, Kentucky
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Barbeiro S, Atalaia-Martins C, Marcos P, Nobre J, Gonçalves C, Aniceto C. Splenic Rupture as a Complication of Colonoscopy. GE-PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2016; 24:188-192. [PMID: 29255749 DOI: 10.1159/000452695] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/09/2016] [Indexed: 12/19/2022]
Abstract
Splenic rupture is a rare but serious complication after colonoscopy, with high global mortality (5%). Diagnosis requires a high index of suspicion because presentation can be subtle, nonspecific, and delayed from hours to days and then not easily attributed to a recent endoscopy. Urgent splenectomy is the most common treatment option. A 73-year-old woman was admitted to the emergency department 8 h following a diagnostic colonoscopy. She presented abdominal pain and syncope. The diagnosis of splenic rupture was made and a splenectomy was urgently performed. The patient's postoperative recovery was uneventful. Splenic rupture is a rare complication of colonoscopy which cannot be underestimated in the differential diagnosis of abdominal pain after this procedure. Splenic injuries may occur in apparently uncomplicated, easy colonoscopies performed by experienced endoscopists, with no risk factors identified, as in this case.
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Affiliation(s)
- Sandra Barbeiro
- Department of Gastroenterology, Centro Hospitalar de Leiria/Pombal, Leiria, Portugal
| | | | - Pedro Marcos
- Department of Gastroenterology, Centro Hospitalar de Leiria/Pombal, Leiria, Portugal
| | - João Nobre
- Department of Surgery, Centro Hospitalar de Leiria/Pombal, Leiria, Portugal
| | - Cláudia Gonçalves
- Department of Gastroenterology, Centro Hospitalar de Leiria/Pombal, Leiria, Portugal
| | - Cristina Aniceto
- Department of Surgery, Centro Hospitalar de Leiria/Pombal, Leiria, Portugal
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