An audit of post-splenectomy prophylaxis – are we following the guidelines?

Ramachandra, J; Bond, Amanda; Ranaboldo, C. J.; Cullis, Jonathan O.

doi:10.1308/003588403766274962

Cited by 45 publications

(26 citation statements)

References 10 publications

(14 reference statements)

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“…In 1996, detailed guidelines for prevention and treatment of infection both in asplenic and hyposplenic individuals were published and have been continually updated [7][8][9]. However, accepted best practices have not been implemented in a significant percentage of these patients [7,10,11]. A study published in 2004 of 100 patients between 1990 and 2000 in Beaumont Hospital found that management of the asplenic patient had not followed these guidelines [11].…”

Section: Introductionmentioning

confidence: 99%

Transforming management of patients undergoing splenectomy in an Irish teaching hospital

et al. 2011

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Section: Introductionmentioning

confidence: 99%

Transforming management of patients undergoing splenectomy in an Irish teaching hospital

et al. 2011

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“…Compliance with these recommendations is poor worldwide, with recent pneumococcal vaccination rates ranging from 60% to 75%. [1][2][3][4] Therefore, many asplenic patients unnecessarily remain at high risk for OPSI following their splenectomies.…”

mentioning

confidence: 99%

Information on the Internet for asplenic patients: a systematic review

Downing

Omar²,

Sabri³

et al. 2011

Can J Surg

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“…Clinical/patient education is one of the measures that can significantly reduce the risk of post-splenectomy sepsis (15). Patients should be aware about post-splenectomy risks and importance of vaccination (11). Higher involvement of all relevant structures dealing with treatment of patients who were subjected to splenectomy (primary health care, public health departments, hospitals) is necessary in order to increase the use of vaccines after splenectomy.…”

Section: Discussionmentioning

confidence: 99%

“…The recommendation for patients is to receive a written information about the post-splenectomy risks, medical alert bracelet and up-to-date vaccination card (11,17). In addition, it is necessary to start using splenectomy registers, because then we will be able to follow up all splenectomized patients and increase the adherence to vaccination (18).…”

Section: Discussionmentioning

confidence: 99%

Reasons for Inadequate Vaccination after Splenectomy

Tanasković¹,

Odalovic²,

Janković³

et al. 2015

Acta Facultatis Medicae Naissensis

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The aim of this study was to analyze the reasons why the guidelines for post-splenectomy vaccination are not being followed. Considering that vaccination reduces the risk of overwhelming post-splenectomy infection, it is important to determine the reasons for inadequate vaccination after splenectomy.Our research was a qualitative study based on interviews with six surgeons, one general practitioner and three patients who underwent splenectomy, and on the review of patient's medical charts and discharge summaries.This study has shown that health care team and patients lack sufficient knowledge about postsplenectomy vaccination. In addition, the study has shown that splenectomy registers, medical bracelets and up-to-date vaccination cards still have not become part of our current practice.Our study has shown that patient education and health care team education is crucial to follow the guidelines for post-splenectomy vaccination, which is similar to most other reports. In order to increase the level of post-splenectomy vaccination, we need to upgrade the education of health care teams and patients. Moreover, we need to start using splenectomy registers, medical bracelets and up-to-date vaccination cards. Key words: splenectomy, vaccination, qualitative, educationCorresponding author:Marko Tanasković e-mail: markotanaskovic55@gmail.com DOI: 10.1515DOI: 10. /afmnai-2015 Acta facultatis medicae Naissensis 2015;32(4):279-286 O r i g i n a l a r t i c l e I NT ROD U CT I ONSurgical removal of the spleen (splenectomy) is performed through emergency surgery due to trauma, and can also be performed for the treatment or diagnosis of malignant and benign diseases. Postsplenectomy sepsis is one of the most serious complications after splenectomy. Pneumococci, meningococci and Haemophilus influenzae are the most common pathogens that cause post-splenectomy sepsis. Almost all of pharmacotherapeutic handbooks recommend vaccination as a preventive measure for these complications two weeks prior to surgery or a week after surgery in emergencies when there is no time for vaccination prior to splenectomy. The use of vaccines is becoming increasingly important due to the appearance of antibiotic-resistant strains of pneumococci. Therefore, all patients before/after splenectomy should be vaccinated against pneumococcus, meningococcus and Haemophilus influenzae to be protected against post-splenectomy sepsis.While information that all patients should be vaccinated after splenectomy has been known since 1970, there are still patients who are not vaccinated or revaccinated after splenectomy. One study in the Netherlands found that out of 130 patients who underwent splenectomy only 103 (79.2%) were vaccinated against pneumococcus (1). The percentage of patients vaccinated against meningococcus and Haemophilus influenzae was even lower (27% and 32%, respectively). These results are unsatisfactory, especially when we take into account the efforts of the professional community to understand the importance of post-splenectomy vaccination. A...

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An audit of post-splenectomy prophylaxis – are we following the guidelines?

Abstract: Conclusions:Results are comparable with other published studies, but are still unsatisfactory for many splenectomy patients. Vaccination rates must be improved and more information given to patients and GPs to allow for appropriate follow-up care.

Cited by 45 publications

References 10 publications

Transforming management of patients undergoing splenectomy in an Irish teaching hospital

Transforming management of patients undergoing splenectomy in an Irish teaching hospital

Information on the Internet for asplenic patients: a systematic review

Reasons for Inadequate Vaccination after Splenectomy

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