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Compliance with Australian splenectomy guidelines in patients undergoing post-traumatic splenectomy at a tertiary centre

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To the Editor: The lack of a functioning spleen is associated with a lifelong risk of overwhelming post-splenectomy infection (OPSI). Historically, mortality rates associated with OPSI have been in excess of 50%.13 OPSI is a preventable illness through vaccination, education, prophylactic antibiotic use and other measures, as summarised in the national Australasian Society for Infectious Diseases (ASID)-endorsed guidelines for prevention of sepsis in asplenic and hyposplenic patients.4

We performed a retrospective cohort study among adult patients who had undergone post-traumatic splenectomy at a tertiary referral centre in Sydney, to assess compliance by health professionals and identify factors that could improve uptake of ASID recommendations. We reviewed hospital medical records and discharge summaries to assess compliance with recommendations before and after the publication of the ASID guidelines.

The Research and Ethics Office of the South Western Sydney Local Health District granted site-specific approval on the basis of low and negligible risk.

A total of 79 patients were identified, 37 in the preguideline group (January 2003 – June 2008) and 42 in the postguideline group (July 2008 – December 2013). Our findings are summarised in the