{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T11:53:33Z","timestamp":1742644413432,"version":"3.37.3"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T00:00:00Z","timestamp":1655424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We sought to identify factors associated with 30\u2010day morbidity, and their impact on 30\u2010day mortality, among patients undergoing splenectomy for immune thrombocytopenic purpura (ITP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the ACS\u2010NSQIP database, patients undergoing splenectomy for ITP were identified (2005\u20132019), and those with and without postoperative complications within 30 days of surgery were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 2483 patients evaluated, 280 (11.3%) developed 30\u2010day morbidity: infection (<jats:italic>n<\/jats:italic>=\u2009145 [5.8%]), venous thromboembolism (<jats:italic>n<\/jats:italic>\u2009=\u200971 [2.9%]), acute renal failure (<jats:italic>n<\/jats:italic>\u2009=\u20097 [0.3%]), respiratory failure (<jats:italic>n<\/jats:italic>\u2009=\u200940 [1.6%]), cardiac arrest\/myocardial infarction (<jats:italic>n<\/jats:italic>\u2009=\u200916 [0.6%]), cerebrovascular accident (<jats:italic>n<\/jats:italic>\u2009=\u20094 [0.2%]), or postoperative blood transfusion (<jats:italic>n<\/jats:italic>\u2009=\u200962 [2.5%]). Risk\u2010factors for 30\u2010day morbidity included age \u226550 years (odds ratio [OR] 1.50, <jats:italic>p<\/jats:italic>\u2009=\u20090.020), body mass index \u226530\u2009kg\/m<jats:sup>2<\/jats:sup> (OR 1.45, <jats:italic>p<\/jats:italic>\u2009=\u20090.023), functional dependence (OR 2.90, <jats:italic>p<\/jats:italic>\u2009=\u20090.009), preoperative albumin &lt;3.5\u2009g\/dL (OR 2.10, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), preoperative platelets &lt;30\u2009000\/\u03bcL (OR 1.54, <jats:italic>p<\/jats:italic>\u2009=\u20090.020), open surgical approach (OR 2.32, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and inpatient status before surgery (OR 1.85, <jats:italic>p<\/jats:italic>\u2009=\u20090.040). Among patients at low\u2010risk for 30\u2010day morbidity (no risk\u2010factors present), the 30\u2010day morbidity rate was 5.0% versus 41.5% for \u22655 risk\u2010factors (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Thirty\u2010day mortality was 1.2%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Thirty\u2010day morbidity and mortality are low with splenectomy for ITP. Select patients have particularly low perioperative risk and may benefit from early splenectomy if initial medical therapy fails.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.26986","type":"journal-article","created":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T07:38:27Z","timestamp":1655451507000},"page":"718-727","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Postsplenectomy morbidity and mortality in patients with immune thrombocytopenic purpura: A national cohort study"],"prefix":"10.1002","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8398-3297","authenticated-orcid":false,"given":"Cimarron E.","family":"Sharon","sequence":"first","affiliation":[{"name":"Department of Surgery Perelman School of Medicine, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2263-3576","authenticated-orcid":false,"given":"Richard J.","family":"Straker","sequence":"additional","affiliation":[{"name":"Department of Surgery Perelman School of Medicine, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhita","family":"Perry","sequence":"additional","affiliation":[{"name":"Department of Surgery Perelman School of Medicine, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John T.","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Surgery Perelman School of Medicine, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgos C.","family":"Karakousis","sequence":"additional","affiliation":[{"name":"Department of Surgery Perelman School of Medicine, University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000966"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2009.01247.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-06-225565"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2017009860"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-09-742353"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-03-1168"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-002-0461-8"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-021-04449-4"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2009.10.003"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1369-7625.2012.00806.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2016.06.031"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.285"},{"issue":"4","key":"e_1_2_9_14_1","first-page":"333","article-title":"Complications of splenectomy","volume":"38","author":"Shatney CH","year":"1987","journal-title":"Acta Anaesthesiol Belg"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.137.8.924"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.03.007"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588414X13814021677593"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.20433"},{"key":"e_1_2_9_19_1","unstructured":"American College of Surgeons.ACS NSQIP Participant Use Data File. 2018 March 3 2021."},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1553-7250(15)41026-8"},{"volume-title":"International classification of diseases: [9th] ninth revision, basic tabulation list with alphabetic index","year":"1978","author":"World Health, O","key":"e_1_2_9_21_1"},{"volume-title":"ICD\u201010: international statistical classification of diseases and related health problems: tenth revision","year":"2004","author":"World Health, O","key":"e_1_2_9_22_1"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000003947"},{"key":"e_1_2_9_24_1","unstructured":"American College of Surgeons.User Guide for the 2018 ACS NSQIP Participant User File. 2018 March 29 2022; 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