Septic arthritis in patients aged 80 and older: a comparison with younger adults

To compare the frequency and characteristics of septic arthritis in patients younger than 80 and aged 80 and older.

Retrospective.

Single hospital center.

Patients admitted between 1979 and 2002 for septic arthritis.

Age, sex, time to diagnosis, predisposing factors, joint, temperature, white blood cell count, microorganism, and short-term outcome.

Of 335 patients, 206 (61.4%) were aged 60 and older, and 42 (12.5%) were 80 and older. The latter had an average age of 84 (range 80-97) and were mainly women (72%). Eighteen of the 42 had at least one risk factor. The mean time to diagnosis was 21 days (range 1 day to 3 months). Twenty patients (47%) had knee involvement, six (14%) shoulder involvement, ten (23.8%) a prosthetic infection, and five (12%) polyarticular infection. Ten (23%) were afebrile. In half of the cases, there was no increase in white blood cell count. The microorganisms isolated were Staphylococcus aureus (n=16, 38%), coagulase negative staphylococci (n=8, 19%), streptococci (n=12, 28%), and gram-negative bacilli (n=6, 14%). The mortality rate increased with age: 0.7% of patients younger than 60, 4.8% of those aged 60 to 79, and 9.5% of those aged 80 and older.

Advanced age is a risk factor for septic arthritis and poor outcome.