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dc.contributor.authorKristinsson, Sigurdur Y*
dc.contributor.authorGridley, Gloria*
dc.contributor.authorHoover, Robert N*
dc.contributor.authorCheck, David*
dc.contributor.authorLandgren, Ola*
dc.date.accessioned2014-08-27T13:45:54Z
dc.date.available2014-08-27T13:45:54Z
dc.date.issued2014-02
dc.date.submitted2014
dc.identifier.citationHaematologica 2014, 99 (2):392-8en
dc.identifier.issn1592-8721
dc.identifier.pmid24056815
dc.identifier.doi10.3324/haematol.2013.092460
dc.identifier.urihttp://hdl.handle.net/2336/325484
dc.descriptionTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.en
dc.description.abstractAlthough preservation of the spleen following abdominal trauma and spleen-preserving surgical procedures have become gold standards, about 22,000 splenectomies are still conducted annually in the USA. Infections, mostly by encapsulated organisms, are the most well-known complications following splenectomy. Recently, thrombosis and cancer have become recognized as potential adverse outcomes post-splenectomy. Among more than 4 million hospitalized USA veterans, we assessed incidence and mortality due to infections, thromboembolism, and cancer including 8,149 cancer-free veterans who underwent splenectomy with a follow-up of up to 27 years. Relative risk estimates and 95% confidence intervals were calculated using time-dependent Poisson regression methods for cohort data. Splenectomized patients had an increased risk of being hospitalized for pneumonia, meningitis, and septicemia (rate ratios=1.9-3.4); deep venous thrombosis and pulmonary embolism (rate ratios=2.2); certain solid tumors: buccal, esophagus, liver, colon, pancreas, lung, and prostate (rate ratios =1.3-1.9); and hematologic malignancies: non-Hodgkin lymphoma, Hodgkin lymphoma, multiple myeloma, acute myeloid leukemia, chronic lymphocytic leukemia, chronic myeloid leukemia, and any leukemia (rate ratios =1.8-6.0). They also had an increased risk of death due to pneumonia and septicemia (rate ratios =1.6-3.0); pulmonary embolism and coronary artery disease (rate ratios =1.4-4.5); any cancer: liver, pancreas, and lung cancer, non-Hodgkin lymphoma, Hodgkin lymphoma, and any leukemia (rate ratios =1.3-4.7). Many of the observed risks were increased more than 10 years after splenectomy. Our results underscore the importance of vaccination, surveillance, and thromboprophylaxis after splenectomy.
dc.description.sponsorshipNational Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland, USAen
dc.language.isoenen
dc.publisherFerrata Storti Foundationen
dc.relation.urlhttp://dx.doi.org/10.3324/haematol.2013.092460en
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912973/en
dc.rightsopenAccessen
dc.subjectKrabbameinen
dc.subjectMiltaen
dc.subjectDánartíðnien
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshAged, 80 and overen
dc.subject.meshDisease-Free Survivalen
dc.subject.meshFollow-Up Studiesen
dc.subject.meshHumansen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshNeoplasms*/mortalityen
dc.subject.meshRetrospective Studiesen
dc.subject.meshSplenectomy*en
dc.subject.meshSurvival Rateen
dc.subject.meshUnited States/epidemiologyen
dc.subject.meshVeteransen
dc.subject.meshNeoplasms*/surgeryen
dc.titleLong-term risks after splenectomy among 8,149 cancer-free American veterans: a cohort study with up to 27 years follow-up.en
dc.typeArticleen
dc.contributor.departmentUniv Iceland, Fac Med, Reykjavik, Iceland, Landspitali Natl Univ Hosp, Dept Hematol, Reykjavik, Iceland, NCI, Div Canc Epidemiol & Genet, NIH, Bethesda, MD 20892 USA, NCI, Ctr Canc Res, NIH, Bethesda, MD 20892 USAen
dc.identifier.journalHaematologicaen
dc.rights.accessOpen Accessen
refterms.dateFOA2018-09-12T13:37:54Z
html.description.abstractAlthough preservation of the spleen following abdominal trauma and spleen-preserving surgical procedures have become gold standards, about 22,000 splenectomies are still conducted annually in the USA. Infections, mostly by encapsulated organisms, are the most well-known complications following splenectomy. Recently, thrombosis and cancer have become recognized as potential adverse outcomes post-splenectomy. Among more than 4 million hospitalized USA veterans, we assessed incidence and mortality due to infections, thromboembolism, and cancer including 8,149 cancer-free veterans who underwent splenectomy with a follow-up of up to 27 years. Relative risk estimates and 95% confidence intervals were calculated using time-dependent Poisson regression methods for cohort data. Splenectomized patients had an increased risk of being hospitalized for pneumonia, meningitis, and septicemia (rate ratios=1.9-3.4); deep venous thrombosis and pulmonary embolism (rate ratios=2.2); certain solid tumors: buccal, esophagus, liver, colon, pancreas, lung, and prostate (rate ratios =1.3-1.9); and hematologic malignancies: non-Hodgkin lymphoma, Hodgkin lymphoma, multiple myeloma, acute myeloid leukemia, chronic lymphocytic leukemia, chronic myeloid leukemia, and any leukemia (rate ratios =1.8-6.0). They also had an increased risk of death due to pneumonia and septicemia (rate ratios =1.6-3.0); pulmonary embolism and coronary artery disease (rate ratios =1.4-4.5); any cancer: liver, pancreas, and lung cancer, non-Hodgkin lymphoma, Hodgkin lymphoma, and any leukemia (rate ratios =1.3-4.7). Many of the observed risks were increased more than 10 years after splenectomy. Our results underscore the importance of vaccination, surveillance, and thromboprophylaxis after splenectomy.


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