Spinal epidural abscess: Does social deprivation influence 1-year mortality?

Area of Science:

• Medical research
• Clinical epidemiology
• Infectious diseases

Background:

• Spinal epidural abscess (SEA) diagnosis is challenging due to non-specific symptoms, often leading to delayed identification.
• Nearly half of SEA patients experience late diagnosis or missed detection.
• Understanding at-risk patient profiles is crucial for timely SEA diagnosis.

Purpose of the Study:

• To investigate the relationship between social deprivation and one-year mortality in patients diagnosed with spinal epidural abscess.
• To identify key demographic, clinical, and social factors associated with mortality in SEA patients.

Main Methods:

• Retrospective analysis of 140 patients diagnosed with spinal epidural abscess at a tertiary referral center (February 2009 - January 2022).
• Data collected included demographics, clinical presentation, medical history, concurrent infections, and social factors.
• Multivariate stepwise regression analysis was used to assess predictors of one-year mortality.

Main Results:

• Of 140 patients, 18 (12.9%) died within one year post-discharge.
• One-year mortality was significantly associated with older age, higher mean neutrophil count, and presence of congestive heart failure.
• No statistically significant association was found between one-year mortality and social deprivation, rurality, or Māori ethnicity.

Conclusions:

• One-year mortality in spinal epidural abscess patients is primarily associated with age, mean neutrophil count, and congestive heart failure.
• Social deprivation did not demonstrate a significant association with one-year mortality in this cohort.
• Identifying patients at highest risk of mortality from spinal epidural abscess remains a complex clinical challenge.