Adherence to vaccination guidelines post splenectomy: A five year follow up study

Abstract Following a splenectomy patients are at increased risk of significant infections. In its most severe form, overwhelming post-splenectomy infection (OPSI) has a mortality rate of up to 80%. In this study we aim to establish the adherence to vaccination and antibiotic national guidelines in s...

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Bibliographic Details
Published in:Journal of infection and public health 2017-11, Vol.10 (6), p.803-808
Main Authors: Boam, Tristan, Sellars, Peter, Isherwood, John, Hollobone, Chloe, Pollard, Cristina, Lloyd, David M, Dennison, Ashley R, Garcea, Giuseppe
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Guideline Adherence
Guidelines
Hospitals, Teaching
Humans
Infectious Disease
Internal Medicine
Male
Middle Aged
Retrospective Studies
Splenectomy
Vaccination
Vaccinations
Young Adult
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Summary:Abstract Following a splenectomy patients are at increased risk of significant infections. In its most severe form, overwhelming post-splenectomy infection (OPSI) has a mortality rate of up to 80%. In this study we aim to establish the adherence to vaccination and antibiotic national guidelines in splenectomised patients. A retrospective study of 100 patients who underwent splenectomy (21 emergency, 79 elective), in two teaching hospitals was undertaken over a five-year period. Patients were followed up for five years. Hospital and GP records were reviewed for adherence to pre, intra and postoperative vaccination, thromboprophylaxis and antibiotic guidance. Eighty-six eligible patients (91.5%) received their Haemophilus influenzae B, meningococcal C and pneumococcus vaccinations peri-operatively. Eighty-one (86%) received post-operative antibiotics. Ninety-nine percent of patients received thromboprophylaxis treatment. Eighty-nine (95%) were treated with long-term antibiotic prophylaxis. Only 20 patients (23%) had an emergency supply of antibiotics. Ninety-five percent of patients were administered an annual influenza vaccination and 84% of eligible patients received a five-year pneumococcal booster vaccination. Improvement in the management of this patient cohort can be achieved by a multidisciplinary approach involving adherence to national guidelines, standardised trust protocols, patient information leaflets and advice detailing risk of infection, standardised GP letters and a splenectomy register to monitor and manage this vulnerable group of patients.
ISSN:1876-0341
1876-035X
DOI:10.1016/j.jiph.2017.01.006