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Publication Type
Journal Article
UWI Author(s)
Author, Analytic
Wright, J. G. ; Hambleton, Ian R. ; Thomas, Peter W. ; Duncan, Newton D.; Venugopal, Sivarajan ; Serjeant, Graham R.
Author Affiliation, Ana.
Surgery, Radiology, Anaesthesia and Intensive Care
Article Title
Postsplenectomy course in homozygous sickle cell disease
Medium Designator
n/a
Connective Phrase
n/a
Journal Title
Journal of Pediatrics
Translated Title
n/a
Reprint Status
Refereed
Date of Publication
1999
Volume ID
134
Issue ID
3
Page(s)
304-09
Language
eng
Connective Phrase
n/a
Location/URL
n/a
ISSN
n/a
Notes
n/a
Abstract
To determine whether children with homozygous sickle cell (SS) disease and splenectomy are at greater risk of death, overwhelming septicemia, or other complications a total of 130 patients with SS treated by splenectomy (46 recurrent acute splenic sequestration, 84 chronic hypersplenism) over a 22.5-year period at the Sickle Cell Clinic of the University Hospital of the West Indies, Kingston, Jamaica, were compared with a control group matched for sex, age, and duration of follow-up in a retrospective review. Deaths and bacteremias were examined over the whole study period. Painful crises, acute chest syndromes, and febrile episodes were compared in the 90 patients completing 5 years of postsplenectomy follow-up. Mortality and bacteremic episodes did not differ between the splenectomy and control groups. Painful crises were more common in the splenectomy group than in the control group (P =.01) but did not differ between splenectomy indications. Acute chest syndrome was more common in the splenectomy group than in the control group (P <.01) and was more common in the acute splenic sequestration group than in the hypersplenism group (P =.01). Febrile events did not differ between the groups or between the indications for splenectomy. CONCLUSION: Splenectomy does not increase the risk of death or bacteremic illness in patients with SS disease and, if otherwise indicated, should not be deferred for these reasons.....
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