Lin HF, et al. - The relationship amongst splenectomy and empyema in Taiwan is examined. The incidence rate ratio between the splenectomy and non-splenectomy groups decreased from 2.87 in the first 5 years of follow-up to 1.73 in the period following the 5 years. Future studies are required to affirm whether a longer follow-up period would further decrease this average ratio. For the splenectomy group, the overall HR of developing empyema was 2.89 after adjusting for age, sex and comorbidities, which were identified from the previous literature. Despite the absence of these comorbidities, the risk of empyema following splenectomy remains high.