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The IFSD Score-A Practical Prognostic Model for Invasive Fungal Spondylodiscitis
Chao-Chun Yang1, Ming-Hsueh Lee1, Chia-Yen Liu2
1Department of Neurosurgery, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan.
Abstract:
Objectives: Invasive fungal spondylodiscitis (IFSD) is rare and could be lethal in certain circumstances. The previous literature revealed limited data concerning its outcomes. This study aimed to establish a risk-scoring system to predict the one-year mortality rate of this disease. Methods: A total of 53 patients from a multi-centered database in Taiwan were included in this study. All the clinicopathological and laboratory data were retrospectively analyzed. Variables strongly related to one-year mortality were identified using a multivariate Cox proportional hazards model. A receiver operating characteristic (ROC) curve was used to express the performance of our IFSD scoring model. Results: Five strong predictors were included in the IFSD score: predisposing immunocompromised state, the initial presentation of either radiculopathy or myelopathy, initial laboratory findings of WBC > 12.0 or <0.4 103/µL, hemoglobin < 8 g/dL, and evidence of candidemia. One-year mortality rates for patients with IFSD scores of 0, 1, 2, 3, and 4 were 0%, 16.7%, 56.3%, 72.7%, and 100%, respectively. The area under the curve of the ROC curve was 0.823. Conclusions: We developed a practical scoring model with easily obtained demographic, clinical, and laboratory parameters to predict the probability of one-year mortality in patients with IFSD. However, more large-scale and international validations would be necessary before this scoring model is commonly used.
Insights
A new scoring system helps predict one-year mortality for invasive fungal spondylodiscitis (IFSD). This tool uses key patient factors to estimate survival chances, aiding clinical decisions for this rare infection.
Area of Science:
- Infectious Diseases
- Medical Research
- Clinical Outcomes
Background:
- Invasive fungal spondylodiscitis (IFSD) is a rare but potentially fatal spinal infection.
- Limited data exists on predicting mortality outcomes for IFSD patients.
- Accurate prognostic tools are needed for effective patient management.
Purpose of the Study:
- To develop and validate a risk-scoring system for predicting one-year mortality in patients with IFSD.
- To identify key clinical and laboratory predictors of mortality in IFSD.
Main Methods:
- Retrospective analysis of 53 patients from a multi-centered Taiwanese database.
- Multivariate Cox proportional hazards model to identify mortality predictors.
- Receiver operating characteristic (ROC) curve analysis to assess model performance.
Main Results:
- Five significant predictors identified: immunocompromised state, neurological deficits (radiculopathy/myelopathy), abnormal white blood cell count, low hemoglobin, and candidemia.
- IFSD scores correlated strongly with one-year mortality rates, ranging from 0% to 100%.
- The developed scoring model demonstrated good predictive accuracy with an Area Under the Curve (AUC) of 0.823.
Conclusions:
- A practical scoring model was developed using accessible demographic, clinical, and laboratory data.
- This IFSD score can predict the probability of one-year mortality.
- Further large-scale international validation is recommended for widespread clinical adoption.
