European Journal of Biomedical and Pharmaceutical Sciences

VACCINATION TIMING IN EMERGENT VS. ELECTIVE SPLENECTOMY: DOES IT INFLUENCE THE INFECTION RISK? A RETROSPECTIVE STUDY IN THE ROYAL MEDICAL SERVICE IN JORDAN

Areej Alasassfeh MD*, Khaled Elfauri MD, Sharf Al-Haddadein MD, Ahmad Alalwan MD, Qutaiba Qatawneh MD, Alaa Albadaina MD.

ABSTRACT

Introduction: The spleen is an immunologically important organ; it plays a vital role in the defense mechanism against certain organisms. All patients who are planned for elective splenectomy should receive vaccines before the procedure; those who undergo emergent splenectomy should receive the vaccine after the procedure. This study aims to compare the infection risk between the preoperative and postoperative vaccination. Methodology: It’s a retrospective comparative study of 230 patients who underwent splenectomies at the Royal Medical Service Hospitals in Jordan over a 2-year duration, from July 2022 to June 2024. Data collected from patients' files and from the National Electronic Medical Records System (HAKEEM) from all military hospitals in Jordan. Patient demographics, time of surgery, time of vaccination, and history of fever or infection after the procedure were recorded. Then all the data was statistically collected and analyzed. The inclusion criteria were all cases that underwent splenectomies as emergent or elective causes and received the Hemophilus, meningococcal, and pneumococcal vaccines before and after the procedure. The study sample is divided into two groups for comparison: Group A (n=110), those who underwent the elective procedures, and Group B (n=120), who underwent emergent splenectomy. Then we followed the patients' data revisions in the emergency department and clinics for 2 years to compare the infection risk after procedures and vaccinations. Results: A total of 230 patients underwent splenectomy, Group A (n=110), who underwent elective splenectomies and received vaccination 14 days before surgery. Group B (n=120), who underwent emergent splenectomies. Male patients were more common in Group B, 85%, whereas the percentage in Group A was completely different. The female percentage accounts for about 60%. The middle-aged (26-50 years) group was the most common and accounted for 76% in both groups. The infection risk in the postoperative group was slightly higher than in the preoperative group, at 5.5% and 4.2%, respectively, with no significant difference (P=0.6). Conclusion: the risk of infection is almost the same in both groups, either giving the vaccination before or after the splenectomy,

Keywords: Splenectomy, Post-Splenectomy Vaccination.