Hospital mortality in hematogenous vertebral osteomyelitis
Objective. To analyze lethal outcomes in patients with hematogenous vertebral osteomyelitis. Material and Methods. Study design: retrospective analysis of medical records. A total of 209 medical records of inpatients who under- went treatment for hematogenous vertebral osteomyelitis in 2006–2017 w...
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| Autores principales: | , , , , |
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| Formato: | article |
| Lenguaje: | EN RU |
| Publicado: |
Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"
2021
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/34cec8ffbcab4b8ea41fe69e091c7e24 |
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| Sumario: | Objective. To analyze lethal outcomes in patients with hematogenous vertebral osteomyelitis.
Material and Methods. Study design: retrospective analysis of medical records. A total of 209 medical records of inpatients who under-
went treatment for hematogenous vertebral osteomyelitis in 2006–2017 were analyzed. Out of them 68 patients (32.5 %) were treated
conservatively, and 141 (67.5 %) – surgically. The risk factors for lethal outcomes were studied for various methods of treatment, and a
statistical analysis was performed.
Results. Hospital mortality (n = 9) was 4.3 %. In patients who died in hospital, average time for diagnosis making was 4 times less
(p = 0.092). The main factors affecting mortality were diabetes mellitus (p = 0.033), type C lesion according to the Pola classification
(p = 0.014) and age over 70 years (p = 0.006). To assess the relationship between hospital mortality and the revealed differences be-
tween the groups, a regression analysis was performed, which showed that factors associated with mortality were Pola type C.4 lesions
(OR 9.73; 95 % CI 1.75–54.20), diabetes mellitus (OR 5.86; 95 % CI 1.14–30.15) and age over 70 years (OR 12.58; 95 % CI 2.50–63.34).
The combination of these factors increased the likelihood of hospital mortality (p = 0.001). Sensitivity (77.8 %) and specificity (84.2 %)
were calculated using the ROC curve. In the group with mortality, the comorbidity index (CCI) was significantly higher (≥4) than in the
group without mortality (p = 0.002). With a CCI of 4 or more, the probability of hospital death increases significantly (OR 10.23; 95 %
CI 2.06–50.82), p = 0.005. Long-term mortality was 4.3 % (n = 9), in 77.8 % of cases the cause was acute cardiovascular pathology, and
no recurrence of vertebral osteomyelitis was detected.
Conclusion. Hospital mortality was 4.3 %, and there was no mortality among patients treated conservatively. The main risk factors
were diabetes mellitus, type C lesion according to Pola and age over 70 years. There was a significant mutual burdening of these factors
(p = 0.001). With CCI ≥4, the probability of death is higher (p = 0.005). |
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