Association of pyogenic spondylitis with congestive heart failure in Korea: a nationwide longitudinal cohort study

Objective: The purpose of this nationwide longitudinal follow-up study was to investigate the risk of congestive heart failure (CHF) in pyogenic spondylitis (PS) patients in Korea. Methods: A total of 628 patients were enrolled in the PS group from January 1, 2004 to December 31, 2015 from the National Health Insurance Service Health Screening cohort. PS was identified using the International Classification of Disease, 10th revision codes M46.2–M46.8 and M49.2–M49.3. The control group consisted of 3,140 subjects with 1:5 age- and sex-stratified matching. The 12-year CHF incidence rates in the PS and control groups were compared by the Kaplan-Meier method. The hazard ratio of CHF was estimated by Cox proportional-hazards regression analysis. Results: During the 12-year follow-up period, 16 patients (2.55%) in the PS group and 43 (1.47%) in the control group developed CHF. The hazard ratio of CHF in the PS group was 6.32 (95% confidence interval [CI], 3.39–11.81) after adjusting for sex and age. The hazard ratio of CHF in the PS group was 6.49 (95% CI, 3.47–12.15) after adjusting for sex, age, and income. The hazard ratio of CHF in the PS group was 6.58 (95% CI, 3.50–12.40) after adjusting for sex, age, income, and comorbid medical disorders. In subgroup analyses, all subgroups showed higher CHF incidence rates in the PS group than in the control group. Conclusion: Our nationwide longitudinal study shows a higher incidence rate of CHF in PS patients.