Changing indications for splenectomy. 30 years' experience.

During the last three decades, 2,4117 splenectomies have been performed at The Ohio State University Hospital. Indications for splenectomy include hypersplenism, incidental to other abdominal procedures, trauma, Hodgkin's staging, and other splenic disease. Hodgkin's staging has become the most frequent indication for splenectomy during the past five years, whereas splenectomy for hypersplenism has decreased. Thrombocytosis (platelet counts greater than 400,000/cu mm) was observed in 47% of all patients. Ninety-three percent of all thromboembolic complications occurred in this group. The overall morbidity of 39% has been decreased to 15% during the last five years. In-hospital mortality has decreased from 9.5% to 6%. Incidental splenectomy, even for benign disease, continues to be associated with complications and death.