Overwhelming Postsplenectomy Severe Infection (OPSI)

In a review of post-splenectomy patients from 1966-96, with a median follow-up of 6.9 years, invasive infection occurred in 2.3% of trauma patients with a 49% mortality rate.6 Patients present with nonspecific flu-like symptoms rapidly progressing to fulminant sepsis, consumptive coagulopathy, bacteremia, and untimely death within 12-48 hours. The infections are typically caused by encapsulated organisms including Streptococcus pneumoniae, Haemophilus Influenzae type B, and Neisseria meningitidis, for which there are effective vaccines. One study demonstrated that only 56.7% of patients receive all vaccines needed.7 Since these patients are at risk for OPSI, there must be a standardized process to provide post-splenectomy vaccination, accurate documentation, and life-long tracking to identify outcomes.