Postsplenectomy vaccination guideline adherence
Ruth Carricoa b c d e f g h i j✉, Linda Gossa b c d e f g h i j, Jodi Wojcikb c d e f g h i j k, Kimberly D. Broughton-Millerb c d e f g h i j k, Karina Pentecostb c d e f g h i j k, Michelle Frisbieb c d e f g h i j k, Stanley Koteya b c d e f g h i j, Deborah Niyongaboa b c d e f g h i j, Matthew V. Bennsb c d e f g h i j l, Anupama Raghurama b c d e f g h i j, Mimia Cynthia Logsdonb c d e f g h i j k m
- aUniversity of Louisville Global Health Program, Division of Infectious Diseases, University of Louisville School of Medicine, Louisville, Kentucky
- b1University of Louisville Global Health ProgramDivision of Infectious Diseases University of Louisville School of Medicine LouisvilleKentucky
- c2 University of Louisville Hospital LouisvilleKentucky
- d3Department of Surgery University of Louisville School of Medicine, University of Louisville LouisvilleKentucky
- e4School of Nursing University of Louisville LouisvilleKentucky
- fAccepted June 17, 2017
- gE‐mail: [email protected]
- hFax: 502‐852‐1796
- iReceived February 06, 2017
- jReceived in revised form May 26, 2017
- kUniversity of Louisville Hospital, Louisville, Kentucky
- lDepartment of Surgery, University of Louisville School of Medicine, University of Louisville, Louisville, Kentucky
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Abstract
BACKGROUND AND PURPOSE: Patients undergoing splenectomy for trauma are at life-long risk for rapidly progressive septicemia. The purpose of this study was to investigate long-term patient understanding and follow-up with recommendations regarding their asplenia. METHODS: Patients undergoing splenectomy for trauma January 2010-December 2014 were analyzed. Medical records were reviewed and telephone follow-up interviews were conducted in October-December 2015. Patients were asked a standard set of questions that included hospitalizations, awareness of infectious risks associated with asplenia, need for revaccination, and vaccines they had received since their index hospitalization. FINDINGS: Two hundred forty-four patients underwent splenectomy during the study period. A total of 95 patients (39%) were included in the study. Thirty (32%) had been hospitalized since their trauma admission. Only 46% were aware of the risks for sepsis and the need to revaccinate. Only 7% reported having rapid access to antibiotics. CONCLUSIONS: Despite uniform education prior to discharge, most patients undergoing splenectomy for trauma were unaware of the risks for sepsis and did not follow recommended guidelines for risk reduction. IMPLICATIONS FOR PRACTICE: Improvements that have direct implications for advanced practice included the need to refer for vaccination, educate regarding infection risks, and facilitate rapid access to antibiotic treatment.
TL;DRMost patients undergoing splenectomy for trauma were unaware of the risks for sepsis and did not follow recommended guidelines for risk reduction, and improvements that have direct implications for advanced practice included the need to refer for vaccination, educate regarding infection risks, and facilitate rapid access to antibiotics. (Semantic Scholar)