Native vertebral osteomyelitis in aged patients: distinctive features. An observational cohort study

Area of Science:

• Infectious Diseases
• Orthopedic Surgery
• Geriatric Medicine

Background:

• Native vertebral osteomyelitis (NVO) is a serious spinal infection.
• Understanding age-related differences in NVO is critical for optimizing patient care.

Purpose of the Study:

• To compare the demographic, clinical, and microbiological profiles of NVO in aged versus younger adult patients.
• To identify key differences that may inform clinical management strategies for elderly NVO patients.

Main Methods:

• Retrospective, observational cohort study.
• Inclusion of adult patients with microbiologically confirmed NVO from 1990-2015.
• Division into two groups: aged (≥65 years) and younger (18-64 years).

Main Results:

• Aged patients had higher rates of healthcare-related infection (40.6% vs 25.7%) and infective endocarditis (38.4% vs 20.2%).
• Despite similar rates of spinal cord compression and abscesses, aged patients experienced higher in-hospital mortality (14.5% vs 6.4%).
• Staphylococcus aureus infection was linked to increased mortality in the aged population.

Conclusions:

• Healthcare-associated infection prevention and high clinical suspicion for infective endocarditis are vital in aged NVO patients.
• The prognosis for NVO is poorer in the elderly, with lower surgical intervention rates.
• Age-specific management approaches are needed for native vertebral osteomyelitis.