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A Single-Center Prospective Cohort Study on Postsplenectomy Sepsis and its Prevention

BACKGROUND: This study evaluated the impact of a dedicated outpatient service on vaccination uptake after splenectomy and on the incidence of postsplenectomy sepsis. METHODS: From 2009 to 2016 at the University Hospital Freiburg (Germany), asplenic patients were referred to a dedicated outpatient se...

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Autores principales: Rieg, Siegbert, Bechet, Lena, Naujoks, Kai, Hromek, Julia, Lange, Berit, Juzek-Küpper, Marc-Fabian, Stete, Katarina, Müller, Matthias C, Jost, Insa, Kern, Winfried V, Theilacker, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7051034/
https://www.ncbi.nlm.nih.gov/pubmed/32158777
http://dx.doi.org/10.1093/ofid/ofaa050
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author Rieg, Siegbert
Bechet, Lena
Naujoks, Kai
Hromek, Julia
Lange, Berit
Juzek-Küpper, Marc-Fabian
Stete, Katarina
Müller, Matthias C
Jost, Insa
Kern, Winfried V
Theilacker, Christian
author_facet Rieg, Siegbert
Bechet, Lena
Naujoks, Kai
Hromek, Julia
Lange, Berit
Juzek-Küpper, Marc-Fabian
Stete, Katarina
Müller, Matthias C
Jost, Insa
Kern, Winfried V
Theilacker, Christian
author_sort Rieg, Siegbert
collection PubMed
description BACKGROUND: This study evaluated the impact of a dedicated outpatient service on vaccination uptake after splenectomy and on the incidence of postsplenectomy sepsis. METHODS: From 2009 to 2016 at the University Hospital Freiburg (Germany), asplenic patients were referred to a dedicated outpatient service, provided with comprehensive preventive care including vaccinations, and enrolled in a prospective cohort study. The impact of the service on vaccination uptake and the occurrence of severe sepsis/septic shock was compared between patients who had splenectomy (or were asplenic) within 3 months of study entry (“early study entry”) and those who had splenectomy (or were asplenic) >3 months before study entry (“delayed study entry”). RESULTS: A total of 459 asplenic patients were enrolled, and 426 patients were followed prospectively over a median period of 2.9 years. Pneumococcal vaccine uptake within 3 months of splenectomy or first diagnosis of asplenia was 27% vs 71% among delayed study entry and early study entry patients, respectively (P < .001). Forty-four episodes of severe sepsis or septic shock occurred in study patients: 22 after study entry and 22 before study entry. Streptococcus pneumoniae was more frequent among sepsis episodes that occurred before study entry (8/22) than after study entry (1/22 episodes). For episodes occurring after study entry, only a higher Charlson comorbidity index score was significantly associated with severe sepsis/septic shock postsplenectomy. CONCLUSIONS: With dedicated outpatient care, high uptake of pneumococcal vaccination postsplenectomy was achieved. Sepsis episodes were largely of nonpneumococcal etiology in patients who had received dedicated postsplenectomy care.
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spelling pubmed-70510342020-03-10 A Single-Center Prospective Cohort Study on Postsplenectomy Sepsis and its Prevention Rieg, Siegbert Bechet, Lena Naujoks, Kai Hromek, Julia Lange, Berit Juzek-Küpper, Marc-Fabian Stete, Katarina Müller, Matthias C Jost, Insa Kern, Winfried V Theilacker, Christian Open Forum Infect Dis Major Article BACKGROUND: This study evaluated the impact of a dedicated outpatient service on vaccination uptake after splenectomy and on the incidence of postsplenectomy sepsis. METHODS: From 2009 to 2016 at the University Hospital Freiburg (Germany), asplenic patients were referred to a dedicated outpatient service, provided with comprehensive preventive care including vaccinations, and enrolled in a prospective cohort study. The impact of the service on vaccination uptake and the occurrence of severe sepsis/septic shock was compared between patients who had splenectomy (or were asplenic) within 3 months of study entry (“early study entry”) and those who had splenectomy (or were asplenic) >3 months before study entry (“delayed study entry”). RESULTS: A total of 459 asplenic patients were enrolled, and 426 patients were followed prospectively over a median period of 2.9 years. Pneumococcal vaccine uptake within 3 months of splenectomy or first diagnosis of asplenia was 27% vs 71% among delayed study entry and early study entry patients, respectively (P < .001). Forty-four episodes of severe sepsis or septic shock occurred in study patients: 22 after study entry and 22 before study entry. Streptococcus pneumoniae was more frequent among sepsis episodes that occurred before study entry (8/22) than after study entry (1/22 episodes). For episodes occurring after study entry, only a higher Charlson comorbidity index score was significantly associated with severe sepsis/septic shock postsplenectomy. CONCLUSIONS: With dedicated outpatient care, high uptake of pneumococcal vaccination postsplenectomy was achieved. Sepsis episodes were largely of nonpneumococcal etiology in patients who had received dedicated postsplenectomy care. Oxford University Press 2020-02-13 /pmc/articles/PMC7051034/ /pubmed/32158777 http://dx.doi.org/10.1093/ofid/ofaa050 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Article
Rieg, Siegbert
Bechet, Lena
Naujoks, Kai
Hromek, Julia
Lange, Berit
Juzek-Küpper, Marc-Fabian
Stete, Katarina
Müller, Matthias C
Jost, Insa
Kern, Winfried V
Theilacker, Christian
A Single-Center Prospective Cohort Study on Postsplenectomy Sepsis and its Prevention
title A Single-Center Prospective Cohort Study on Postsplenectomy Sepsis and its Prevention
title_full A Single-Center Prospective Cohort Study on Postsplenectomy Sepsis and its Prevention
title_fullStr A Single-Center Prospective Cohort Study on Postsplenectomy Sepsis and its Prevention
title_full_unstemmed A Single-Center Prospective Cohort Study on Postsplenectomy Sepsis and its Prevention
title_short A Single-Center Prospective Cohort Study on Postsplenectomy Sepsis and its Prevention
title_sort single-center prospective cohort study on postsplenectomy sepsis and its prevention
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7051034/
https://www.ncbi.nlm.nih.gov/pubmed/32158777
http://dx.doi.org/10.1093/ofid/ofaa050
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