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Pyogenic Spondylodiscitis: Risk Factors for Adverse Clinical Outcome in Routine Clinical Practice.

John D Widdrington1, Ingrid Emmerson2,3, Milo Cullinan4

  • 1Department of Infection and Tropical Medicine, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK. j.widdrington@nhs.net.

Medical Sciences (Basel, Switzerland)
|November 2, 2018
PubMed
Summary
This summary is machine-generated.

Pyogenic spondylodiscitis often leads to poor outcomes, with over half of patients experiencing neurological impairment. Factors like diabetes and neurological deficits at diagnosis predict unfavorable results in this spinal infection.

Keywords:
antibioticsbacterialoutcomesspondylodiscitisvertebral osteomyelitis

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Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Neurology

Background:

  • Pyogenic spondylodiscitis is a serious spinal infection.
  • It can lead to significant morbidity and mortality.
  • Identifying predictive factors for poor outcomes is crucial.

Purpose of the Study:

  • To describe clinical features and outcomes of pyogenic spondylodiscitis.
  • To identify factors associated with unfavorable clinical outcomes.
  • To inform early diagnosis and management strategies.

Main Methods:

  • Prospective identification of 91 cases at a tertiary center.
  • Retrospective analysis of clinical records.
  • Binary regression analysis to identify outcome predictors.

Main Results:

  • Median 26 days from symptom onset to diagnosis.
  • 51% of patients presented with neurological impairment.
  • Staphylococcus aureus was the most common pathogen (81% microbiological diagnosis).
  • Treatment included prolonged hospitalization (median 40.5 days), long antibiotic courses (98%), and surgery (42%).
  • Only 32% of patients achieved a favorable clinical outcome; 7% died.
  • Independent predictors of unfavorable outcomes included diabetes mellitus, neurological impairment at presentation, longer symptom duration, and spinal cord/cauda equina compression.

Conclusions:

  • Pyogenic spondylodiscitis is associated with substantial morbidity.
  • Adverse outcomes can be predicted by factors present at diagnosis.
  • Early identification of risk factors may improve patient management and outcomes.