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

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journal contribution
posted on 15.05.2018, 12:28 by T. Boam, P. Sellars, John Isherwood, Chloe Hollobone, Cristina Pollard, David M. Lloyd, Ashley R. Dennison, Giuseppe Garcea
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.

History

Citation

Journal of Infection and Public Health, 2017, 10 (6), pp. 803-808

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Cardiovascular Sciences

Version

VoR (Version of Record)

Published in

Journal of Infection and Public Health

Publisher

Elsevier

issn

1876-0341

eissn

1876-035X

Acceptance date

07/01/2017

Copyright date

2017

Available date

15/05/2018

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https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S1876034117300060?returnurl=https://linkinghub.elsevier.com/retrieve/pii/S1876034117300060?showall=true&referrer=

Language

en

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