Correlation between kidney function and mortality in pyogenic spondylodiscitis: the glomerular filtration rate (GFR)...

Area of Science:

• Nephrology
• Infectious Diseases
• Surgical Outcomes

Background:

• Pyogenic spondylodiscitis is a severe spinal infection with high mortality.
• Known risk factors include obesity, neurological impairment, and advanced age.
• In-hospital mortality suggests additional contributing factors, prompting investigation into kidney function.

Purpose of the Study:

• To evaluate kidney function, specifically glomerular filtration rate (GFR), as a risk factor for increased morbidity and mortality in pyogenic spondylodiscitis.
• To correlate preoperative GFR with clinical outcomes such as mortality, length of hospital stay, and perioperative complications.

Main Methods:

• Retrospective review of 366 patients with pyogenic spondylodiscitis, with 255 included in the final analysis.
• Collection of clinical, laboratory, and surgical data, with a minimum follow-up of three months.
• Analysis of mortality, length of stay, and perioperative complications as primary outcome measures.

Main Results:

• Patients with a GFR < 59 mL/min had a longer hospital stay (average 5 days longer).
• Mortality significantly increased with decreased GFR: 17.6% for GFR 30-59 mL/min and 30.4% for GFR < 29 mL/min (p=0.003).
• Impaired GFR correlated with increased postoperative complications (OR 4.7) and intensive care unit (ICU) stay (OR 8.7).

Conclusions:

• Preoperative glomerular filtration rate (GFR) is a significant predictor of in-hospital mortality in pyogenic spondylodiscitis patients, correlating with KDIGO stages.
• A GFR < 29 mL/min is associated with longer ICU stays, increased postoperative complications, and extended total hospital stays.
• Preoperative GFR serves as a valuable marker of kidney function and a predictive risk factor for the clinical course of pyogenic spondylodiscitis.