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Thromb Haemost 2016; 115(01): 176-183
DOI: 10.1160/TH15-05-0381
Stroke, Systemic or Venous Thromboembolism
Schattauer GmbH Schattauer

Risk of venous thromboembolism in patients with splenic injury and splenectomy

A nationwide cohort study
Jiun-Nong Lin
1   Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
2   School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
3   Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
,
Hsuan-Ju Chen
4   Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
5   College of Medicine, China Medical University, Taichung, Taiwan
,
Ming-Chia Lin
6   Department of Nuclear Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
,
Chung-Hsu Lai
3   Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
,
Hsi-Hsun Lin
3   Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
,
Chih-Hui Yang
7   General Education Center, Meiho University, Pingtung, Taiwan
,
Chia-Hung Kao
8   Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
9   Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
› Author Affiliations
Further Information

Publication History

Received: 06 May 2015

Accepted after major revision: 21 July 2015

Publication Date:
22 November 2017 (online)

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Summary

The spleen is a crucial organ in humans. However, little is known about the association of venous thromboembolism (VTE) with splenic injury and splenectomy in trauma patients. The aim of this study was to determine the subsequent risk of VTE following splenic injury and splenectomy. A nationwide retrospective cohort study was conducted by analysing data from the National Health Insurance Research Database in Taiwan. We included 6,162 splenic injury patients (3,033 splenectomised and 3,129 nonsplenectomised patients) and 24,648 comparison patients who were selected by frequency match based on sex, age, and the index year during 2000–2006. All patients were followed until the occurrence of VTE, 31 December, 2011, death, or withdrawal from the insurance program. The age of patients with splenic injury was 41.93 ± 16.44 years. The incidence rates of VTE were 11.81, 8.46, and 5.21 per 10,000 person-years in the splenic injury patients with splen -ectomy, splenic injury patients without splenectomy, and comparison patients, respectively. Compared with the comparison cohort, splenic injury patients with splenectomy exhibited a 2.21-fold risk of VTE (95 % confidence interval [CI], 1.43–3.43), whereas those without splenectomy exhibited a 1.71-fold risk of VTE (95 % CI, 1.05–2.80). The overall incidence rate of VTE was 1.97-fold higher in the splenic injury cohort than the comparison cohort (95 % CI, 1.38–2.81). Although splenectomy increased the risk of VTE 1.35-fold compared with no splenectomy, the difference was not statistically significant (95 % CI, 0.74–2.45). These results may alert physicians and patients to the complications of splenic injury and splenectomy.

Keywords

Deep-vein thrombosis - portal vein thrombosis - pulmonary embolism - splenectomy - splenic injury - venous thromboembolism

 

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