Predictor of spontaneous rupture of malarial spleen: a systematic review and meta-analysis

Abstract

Background: Spontaneous pathological rupture of the malarial spleen (SPRMS) is a rare but serious complication that has no known predictor in the medical literature. This study aims to report a systematic review of the search for a predictor for SPRMS and the recent changes in the management trends and outcomes of this problem.
Methods: A systematic review of 122 cases from January of 2000 through March of 2024 was conducted and linear regression was computed to search for predicting factors for SPRMS.
Results: Plasmodium vivax (P. vivax) was the most common cause of SPRMS among local citizens, while Plasmodium falciparum (P. Falciparum) was predominant among infected travelers. Fifty patients underwent splenectomy. Despite being a confounding factor in logistic regression, blood pressure could be the sole predictor of SPRMS.
Conclusion: Recent management trends have shown a tendency toward conservative treatment to preserve splenic immunological functions. To our knowledge, this is the first report on a predicting factor for SPRMS. This is important for early diagnosis and health management, as securing patient safety is a cornerstone of clinical governance in emergency settings.