Predictors of One-Year Mortality in Hospitalized Patients with Splenic Infarction: Survival Analysis of a Retrospective Cohort in Taiwan.

Background: Splenic infarction, an uncommon disease, has been demonstrated to be associated with substantial short-term mortality. Given the limited evidence on long-term mortality, this investigation examined the clinical and radiological characteristics of splenic infarction, its long-term prognosis, and predictors of mortality. Methods: This retrospective cohort study at a tertiary care hospital in Taiwan enrolled adult inpatients with first-episode splenic infarction diagnosed on computed tomography from January 2011 to May 2022. The primary outcome was 1-year all-cause mortality. Kaplan-Meier analysis and multivariate weighted Cox regression were applied for survival analysis. Results: The cohort included 304 individuals with an average age of 65.4 years. The mean CCI was 6, and active malignancy was observed in 49%. The estimated 1-year all-cause mortality rate was 61%, and the median survival time was 89 days. Compared with survivors, non-survivors exhibited significantly higher rates of left-sided pleural effusion, peri-splenic ascites, multiple or total infarction, and both portal and splenic vein thrombosis on CT imaging. Older age, active malignancy, decreased hemoglobin levels, low platelet counts, prolonged INR, elevated D-dimer, and peri-splenic ascites were independent predictors of mortality. Conclusion: In splenic infarction, 1-year mortality is notably high. The identified independent prognostic factors included age, malignancy, laboratory findings, and radiologic features. These findings may assist clinicians in early risk stratification for hospitalized patients with splenic infarction.