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:	Aleksandr Yu. Bazarov, Konstantin S. Sergeyev, Aleksey O. Faryon, Roman V. Paskov, Ilya A. Lebedev
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
Materias:	hematogenous vertebral osteomyelitis spondylodiscitis spondylitis hospital mortality Surgery RD1-811
Acceso en línea:	https://doaj.org/article/34cec8ffbcab4b8ea41fe69e091c7e24
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spelling	oai:doaj.org-article:34cec8ffbcab4b8ea41fe69e091c7e242021-11-23T08:21:33ZHospital mortality in hematogenous vertebral osteomyelitis10.14531/ss2021.3.86-931810-89972313-1497https://doaj.org/article/34cec8ffbcab4b8ea41fe69e091c7e242021-09-01T00:00:00Zhttps://www.spinesurgery.ru/jour/article/view/1832/1829https://doaj.org/toc/1810-8997https://doaj.org/toc/2313-1497Objective. 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).Aleksandr Yu. BazarovKonstantin S. SergeyevAleksey O. FaryonRoman V. PaskovIlya A. LebedevMinistry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"articlehematogenous vertebral osteomyelitisspondylodiscitisspondylitishospital mortalitySurgeryRD1-811ENRUХирургия позвоночника, Vol 18, Iss 3, Pp 86-93 (2021)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	hematogenous vertebral osteomyelitis spondylodiscitis spondylitis hospital mortality Surgery RD1-811
spellingShingle	hematogenous vertebral osteomyelitis spondylodiscitis spondylitis hospital mortality Surgery RD1-811 Aleksandr Yu. Bazarov Konstantin S. Sergeyev Aleksey O. Faryon Roman V. Paskov Ilya A. Lebedev Hospital mortality in hematogenous vertebral osteomyelitis
description	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).
format	article
author	Aleksandr Yu. Bazarov Konstantin S. Sergeyev Aleksey O. Faryon Roman V. Paskov Ilya A. Lebedev
author_facet	Aleksandr Yu. Bazarov Konstantin S. Sergeyev Aleksey O. Faryon Roman V. Paskov Ilya A. Lebedev
author_sort	Aleksandr Yu. Bazarov
title	Hospital mortality in hematogenous vertebral osteomyelitis
title_short	Hospital mortality in hematogenous vertebral osteomyelitis
title_full	Hospital mortality in hematogenous vertebral osteomyelitis
title_fullStr	Hospital mortality in hematogenous vertebral osteomyelitis
title_full_unstemmed	Hospital mortality in hematogenous vertebral osteomyelitis
title_sort	hospital mortality in hematogenous vertebral osteomyelitis
publisher	Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"
publishDate	2021
url	https://doaj.org/article/34cec8ffbcab4b8ea41fe69e091c7e24
work_keys_str_mv	AT aleksandryubazarov hospitalmortalityinhematogenousvertebralosteomyelitis AT konstantinssergeyev hospitalmortalityinhematogenousvertebralosteomyelitis AT alekseyofaryon hospitalmortalityinhematogenousvertebralosteomyelitis AT romanvpaskov hospitalmortalityinhematogenousvertebralosteomyelitis AT ilyaalebedev hospitalmortalityinhematogenousvertebralosteomyelitis
_version_	1718416817853038592

Hospital mortality in hematogenous vertebral osteomyelitis

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