Clinical Outcomes in Older Patients Aged over 75 Years Who Underwent Early Surgical Treatment for Pyogenic Vertebral Osteomyelitis

Older patients with pyogenic vertebral osteomyelitis (PVO) usually have more medical comorbidities compared with younger patients, and present with advanced infections from different causative organisms. To aid surgical decision-making, we compared surgical outcomes of older patients with PVO to tho...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Jeong Hwan Lee, Jihye Kim, Tae-Hwan Kim
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	pyogenic vertebral osteomyelitis spondylodiscitis neurologic deficit spinal surgery decompression instrumentation Medicine R
Acceso en línea:	https://doaj.org/article/afb5b1b08fa24a1182e8778fd3625067
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:afb5b1b08fa24a1182e8778fd3625067
record_format	dspace
spelling	oai:doaj.org-article:afb5b1b08fa24a1182e8778fd36250672021-11-25T18:02:58ZClinical Outcomes in Older Patients Aged over 75 Years Who Underwent Early Surgical Treatment for Pyogenic Vertebral Osteomyelitis10.3390/jcm102254512077-0383https://doaj.org/article/afb5b1b08fa24a1182e8778fd36250672021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5451https://doaj.org/toc/2077-0383Older patients with pyogenic vertebral osteomyelitis (PVO) usually have more medical comorbidities compared with younger patients, and present with advanced infections from different causative organisms. To aid surgical decision-making, we compared surgical outcomes of older patients with PVO to those who underwent nonoperative treatment. We identified the risk factors for adverse post-operative outcomes, and analyzed the clinical risks from further spinal instrumentation. This retrospective comparative study included 439 patients aged ≥75 years with PVO. Multivariable analysis was performed to compare treatment outcomes among three groups: 194, 130, and 115 patients in the non-operative, non-instrumented, and instrumented groups, respectively. The risk factors for adverse outcomes after surgical treatment were evaluated using a logistic regression model, and the estimates of the multivariable models were internally validated using bootstrap samples. Recurrence and mortality of these patients were closely associated with neurologic deficits, and increased surgical invasiveness, resulting from additional spinal instrumentation, did not increase the risk of recurrence or mortality. We propose that surgical treatment for these patients should focus on improving neurologic deficits through immediate and sufficient removal of abscesses. Spinal instrumentation can be performed if indicated, within reasonable clinical risk.Jeong Hwan LeeJihye KimTae-Hwan KimMDPI AGarticlepyogenic vertebral osteomyelitisspondylodiscitisneurologic deficitspinal surgerydecompressioninstrumentationMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5451, p 5451 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pyogenic vertebral osteomyelitis spondylodiscitis neurologic deficit spinal surgery decompression instrumentation Medicine R
spellingShingle	pyogenic vertebral osteomyelitis spondylodiscitis neurologic deficit spinal surgery decompression instrumentation Medicine R Jeong Hwan Lee Jihye Kim Tae-Hwan Kim Clinical Outcomes in Older Patients Aged over 75 Years Who Underwent Early Surgical Treatment for Pyogenic Vertebral Osteomyelitis
description	Older patients with pyogenic vertebral osteomyelitis (PVO) usually have more medical comorbidities compared with younger patients, and present with advanced infections from different causative organisms. To aid surgical decision-making, we compared surgical outcomes of older patients with PVO to those who underwent nonoperative treatment. We identified the risk factors for adverse post-operative outcomes, and analyzed the clinical risks from further spinal instrumentation. This retrospective comparative study included 439 patients aged ≥75 years with PVO. Multivariable analysis was performed to compare treatment outcomes among three groups: 194, 130, and 115 patients in the non-operative, non-instrumented, and instrumented groups, respectively. The risk factors for adverse outcomes after surgical treatment were evaluated using a logistic regression model, and the estimates of the multivariable models were internally validated using bootstrap samples. Recurrence and mortality of these patients were closely associated with neurologic deficits, and increased surgical invasiveness, resulting from additional spinal instrumentation, did not increase the risk of recurrence or mortality. We propose that surgical treatment for these patients should focus on improving neurologic deficits through immediate and sufficient removal of abscesses. Spinal instrumentation can be performed if indicated, within reasonable clinical risk.
format	article
author	Jeong Hwan Lee Jihye Kim Tae-Hwan Kim
author_facet	Jeong Hwan Lee Jihye Kim Tae-Hwan Kim
author_sort	Jeong Hwan Lee
title	Clinical Outcomes in Older Patients Aged over 75 Years Who Underwent Early Surgical Treatment for Pyogenic Vertebral Osteomyelitis
title_short	Clinical Outcomes in Older Patients Aged over 75 Years Who Underwent Early Surgical Treatment for Pyogenic Vertebral Osteomyelitis
title_full	Clinical Outcomes in Older Patients Aged over 75 Years Who Underwent Early Surgical Treatment for Pyogenic Vertebral Osteomyelitis
title_fullStr	Clinical Outcomes in Older Patients Aged over 75 Years Who Underwent Early Surgical Treatment for Pyogenic Vertebral Osteomyelitis
title_full_unstemmed	Clinical Outcomes in Older Patients Aged over 75 Years Who Underwent Early Surgical Treatment for Pyogenic Vertebral Osteomyelitis
title_sort	clinical outcomes in older patients aged over 75 years who underwent early surgical treatment for pyogenic vertebral osteomyelitis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/afb5b1b08fa24a1182e8778fd3625067
work_keys_str_mv	AT jeonghwanlee clinicaloutcomesinolderpatientsagedover75yearswhounderwentearlysurgicaltreatmentforpyogenicvertebralosteomyelitis AT jihyekim clinicaloutcomesinolderpatientsagedover75yearswhounderwentearlysurgicaltreatmentforpyogenicvertebralosteomyelitis AT taehwankim clinicaloutcomesinolderpatientsagedover75yearswhounderwentearlysurgicaltreatmentforpyogenicvertebralosteomyelitis
_version_	1718411701572861952

Clinical Outcomes in Older Patients Aged over 75 Years Who Underwent Early Surgical Treatment for Pyogenic Vertebral Osteomyelitis

Ejemplares similares