椎体骨髓炎的早期和晚期死亡率：诊断后一年内死亡。

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2025-05-09 DOI:10.1007/s15010-025-02541-9

Nikolaus Kernich, Arian Abi-Chokami, Norma Jung, Dorothee Jochimsen, Krishnan Sircar, Ada Marie Hoffmann, Stefan Meuser, Peer Eysel, Carolyn Weber, Juan Manuel Vinas-Rios, Ayla Yagdiran, Norma Jung, Ayla Yagdiran, Nikolaus Kernich, Krishnan Sircar, Julia Fischer, Dorothee Jochimsen, Carolyn Weber, Charlotte Meyer-Schwickerath

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引用次数: 0

摘要

目的：椎体骨髓炎（VO）是一种与高死亡率相关的严重临床疾病，特别是在诊断后的第一年。这项单中心前瞻性队列研究的目的是确定和比较影响保守治疗和手术治疗VO患者早期和晚期死亡率的预测因素。方法：我们进行了一项单中心前瞻性队列研究，纳入2008年至2020年在德国一家三级中心接受VO治疗的患者，以确定早期（诊断后30天内死亡）和晚期死亡率（诊断后31天至365天死亡）。此外，还进行了多变量分析，以分析早期和晚期死亡的预测风险因素。结果：共纳入323例患者。19%的患者在确诊后一年内死亡。早期死亡占5%，晚期死亡占14%。多变量分析显示慢性肾脏疾病（CKD） (OR: 13.2, 95% CI 5.7-30.3；p 2 (HR: 5.2, 95% CI 2.6 ~ 10.6；p 70岁(HR: 2.4, 95% CI 1.6-3.7；结论：1 / 5的VO患者在诊断后一年内死亡。第一年死亡的危险因素包括慢性肾病和菌血症。因此，这些患者尤其应在术后一年内密切监测。

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Early and late mortality in vertebral osteomyelitis: who dies within the first year after diagnosis.

Objective: Vertebral osteomyelitis (VO) is a severe clinical entity associated with high mortality rates, especially within the first year after diagnosis. The aim of this single-center prospective cohort study was to identify and compare predictive factors influencing early and late mortality in patients with conservatively and surgically treated VO.

Methods: We conducted a single-center prospective cohort study including patients treated for VO between 2008 and 2020 in a tertiary center in Germany to determine early (death within 30 days after diagnosis) and late mortality (death between day 31 and 365 after diagnosis). Additionally, multivariable analyses were performed to analyze predictive risk factors for early and late mortality.

Results: A total of 323 patients were included. 19% died within the first year after diagnosis. Early mortality occurred in 5% and late mortality in 14% of cases. Multivariable analysis revealed chronic kidney disease (CKD) (OR: 13.2, 95% CI 5.7-30.3; p < 0.001) and MSSA (OR: 4.0, 95% CI 1.4-11.1; p = 0.008) as independent risk factors for early mortality, whereas ASA score > 2 (HR: 5.2, 95% CI 2.6-10.6; p < 0.001), age > 70 years (HR: 2.4, 95% CI 1.6-3.7; p < 0.001), CKD (HR: 1.9, 95% CI 1.3-3.0; p = 0.003) and bacteremia (HR: 1.8, 95% CI 1.2-2.7; p = 0.002) were identified as independent risk factors for late mortality.

Conclusion: One out of five VO patients dies within the first year after diagnosis. Risk factors for mortality within the first year include CKD and bacteremia. As a consequence in particular those patients should be closely monitored within the first year after.

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.