The establishment of a spleen registry has helped improve the health of patients who have had their spleens surgically removed or whose spleens do not function for other reasons, according to research published in the Medical Journal of Australia.
Inclusion in the Victorian Spleen Registry (VSR) increased patients' adherence to guidelines about prophylactic and emergency antibiotics and vaccinations, the authors reported.
Led by Dr Julie Wang, a haematology registrar at the Alfred Hospital in Melbourne, the researchers mailed a survey to all patients who had been registered on the VSR for at least 5 months, asking about their compliance with the guidelines.
They found that the longer the time since surgery, the lower the rate of compliance for both the use of prophylactic antibiotics (82.9% at less than 2 years since surgery versus 27.4% at more than 30 years since surgery) and the availability of emergency antibiotics (74.4% at less than 2 years versus 60% at more than 30 years post-surgery).
Patients with no spleen or a dysfunctional spleen have a greater than 50 times higher risk of developing serious infections than the general population. Although rare, overwhelming post splenectomy infection (OPSI) has a mortality rate of 40% to 70%, and is a lifelong risk.
That risk led to the development of guidelines of which the VSR, established in 2003, regularly reminds registered patients. These guidelines include:
- Education: awareness of risk and preventive measures, including a clear action plan for febrile illness, animal bite or overseas travel
- Vaccination: Keeping up to date with all relevant inoculations specific to post-splenectomy patients, as well as the annual influenza vaccine
- Antibiotic prophylaxis: Antibiotic therapy is recommended lifelong for immunosuppressed patients and at for least 2 years post-splenectomy for others, and recommendations include keeping an emergency supply of antibiotics in case of febrile illness.
"Our results suggest that providing educational material and regular reminders to patients effectively promotes adherence to recommended measures, which is likely to help prevent serious infections in patients with asplenia.", the authors concluded.
Spleen Service/Registry website is spleen.org.au.