Septic arthritis in a tertiary care hospital

To study the epidemiological features of septic arthritis in the adult population and to identify the risk factors for mortality in septic arthritis.

A five year reterospective study was performed on cases with septic arthritis admitted in our hospital between January 1999 and December 2004. Patients were identified according to ICD codes, 711.00. Data was recorded on a standardized data sheet and analyzed by SPSS 11.5 software.

A total of 116 patients were identified, 69 were male (59.5%) and 47 female (40.55%). Mean age of patients was 49.22 years. The most common presenting clinical features were joint swelling (99.1%) and fever (60.3%), Knee joint was the most common joint involved (65.5%) followed by hip (11.2%). Gram stains of synovial fluid was done in 67.2% of cases out of which 22.4% had positive stains. Staphylococcus aureus was the most common organism isolated from blood as well as synovial fluid (18.8%). Mean haemoglobin was 10.83gm/dl and 57.8% of patients had total leukocyte count less than 11,000/cumm. Platelet count was greater than 150,000/cumm in 90.5% patients. Hypertension, renal failure, chronic liver disease and elevated ESR were identified as some of the potential risk factors for higher mortality in a cohort with septic arthritis.

Septic arthritis is associated with significant morbidity and mortality. These results highlight the importance of obtaining cultures before starting any treatment.