Postsplenectomy morbidity and mortality in patients with immune thrombocytopenic purpura: A national cohort study

Background We sought to identify factors associated with 30‐day morbidity, and their impact on 30‐day mortality, among patients undergoing splenectomy for immune thrombocytopenic purpura (ITP). Methods Using the ACS‐NSQIP database, patients undergoing splenectomy for ITP were identified (2005–2019), and those with and without postoperative complications within 30 days of surgery were compared. Results Of 2483 patients evaluated, 280 (11.3%) developed 30‐day morbidity: infection (n= 145 [5.8%]), venous thromboembolism (n = 71 [2.9%]), acute renal failure (n = 7 [0.3%]), respiratory failure (n = 40 [1.6%]), cardiac arrest/myocardial infarction (n = 16 [0.6%]), cerebrovascular accident (n = 4 [0.2%]), or postoperative blood transfusion (n = 62 [2.5%]). Risk‐factors for 30‐day morbidity included age ≥50 years (odds ratio [OR] 1.50, p = 0.020), body mass index ≥30 kg/m2 (OR 1.45, p = 0.023), functional dependence (OR 2.90, p = 0.009), preoperative albumin