Which of the following patients is at highest risk for OPSI?
A. A 30-year old who underwent splenectomy for ITPWhile the all lifetime risk of OPSI is low (ranging from <1-5%) the consequences are serious. The reason for splenectomy is the single most influential determinant of OPSI risk. There is evidence that those who undergo splenectomy for hematologic disease are far more susceptible to OPSI than patients who undergo splenectomy for trauma or iatrogenic reasons. When taking age into consideration children who are 5 years of age or younger and adults who are 50 years of age or older seem to be at an elevated risk. The interval since splenectomy also seems to be a factor with the greatest risk occurring in the first 2 years after splenectomy, however, it is important to remember that cases of OPSI can occur decades later and asplenic patients remain at lifelong risk.