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Life Expectancy Is Poor in Patients with Diffuse Idiopathic Skeletal Hyperostosis-Related Pyogenic Vertebral

Kentaro Yamada1,2, Makoto Ieguchi1, Shinji Takahashi2

  • 1Department of Orthopaedic Surgery, Fuchu Hospital, Izumi, Japan.

Spine Surgery and Related Research
|December 23, 2022
PubMed
Abstract

Insights

Patients with pyogenic vertebral osteomyelitis (PVO) in segments affected by diffuse idiopathic skeletal hyperostosis (DISH) face significantly higher mortality. DISH is an independent risk factor for poor outcomes in PVO patients.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Rheumatology

Background:

  • Pyogenic vertebral osteomyelitis (PVO) is a severe infection with potentially fatal outcomes.
  • Diffuse idiopathic skeletal hyperostosis (DISH) is an age-related condition that can affect spinal stability and increase mortality.
  • The impact of DISH on PVO clinical outcomes remains understudied.

Purpose of the Study:

  • To investigate the association between DISH and mortality rates in patients treated for PVO.
  • To determine if PVO occurring in DISH-affected spinal segments influences patient survival.

Main Methods:

  • Retrospective cohort study of 55 patients hospitalized for PVO.
  • DISH-related PVO defined as infection within or adjacent to DISH-ossified spinal segments.
  • Comparison of mortality rates and survival probabilities between DISH-related and non-DISH-related PVO groups.

Main Results:

  • The mortality rate was substantially higher in the DISH-related PVO group (62%) compared to the non-DISH-related group (23%).
  • DISH-related PVO was identified as an independent risk factor for mortality (adjusted hazard ratio, 2.79).
  • Patients with DISH-related PVO exhibited significantly shorter survival probabilities.

Conclusions:

  • DISH-related PVO is linked to increased mortality and reduced life expectancy.
  • PVO in DISH-ossified segments should be considered a significant risk factor for mortality.
  • Recognizing DISH as a risk factor is crucial for optimizing PVO treatment strategies.
Keywords:
diffuse idiopathic skeletal hyperostosismortalitypropensity score-adjusted analysispyogenic vertebral osteomyelitissingle institution

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