Splenectomy is associated with a higher risk for venous thromboembolism: A prospective cohort study

• This prospective observational study investigated the VTE risk following splenectomy.
• Splenectomy patients were compared with those undergoing any other abdominal surgery.
• Splenectomy was associated with an increased risk for in-hospital VTE development.
• This increased VTE risk is independent of the development of reactive thrombocytosis.

BackgroundThrombocytosis following splenectomy is a common occurrence. Whether this thrombocytosis leads to a higher risk for venous thromboembolism (VTE) remains unclear. This investigation aimed to determine if splenectomy increases the risk for VTE.MethodsThis was a prospective study conducted in the SICU between 1/2011 and 11/2013 investigating the VTE risk in patients undergoing a splenectomy compared with those undergoing any other abdominal procedure.ResultsIn total 2503 patients were admitted to the SICU: 37 (2%) after a splenectomy and 638 (26%) after any other abdominal surgery. Splenectomy patients had a higher incidence of VTE compared to patients undergoing any other abdominal procedure (29.7% vs. 12.1%, p < 0.01). After adjustment, splenectomy was associated with a higher adjusted risk for VTE compared to the no-splenectomy group (AOR [95% CI]: 2.6 [1.2, 5.9], p = 0.02). Reactive thrombocytosis did not predict the development of VTE.ConclusionSplenectomy increases the risk for VTE, however reactive thrombocytosis is not associated with this higher incidence. Further investigations are required to characterize the pathophysiologic mechanisms of VTE development following splenectomy.