In-Hospital Mortality from Spondylodiscitis: Insights from a Single-Center Retrospective Study
(1) Background: There is a marked proportion of spondylodiscitis patients who die during the early stage of the disease despite the applied therapy. This study investigates this early mortality and explores the associated risk factors. (2) Methods: We conducted a retrospective analysis of spondylodi...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/23/7228 |
| _version_ | 1797399988325580800 |
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| author | Ann-Kathrin Joerger Carolin Albrecht Nicole Lange Bernhard Meyer Maria Wostrack |
| author_facet | Ann-Kathrin Joerger Carolin Albrecht Nicole Lange Bernhard Meyer Maria Wostrack |
| author_sort | Ann-Kathrin Joerger |
| collection | DOAJ |
| description | (1) Background: There is a marked proportion of spondylodiscitis patients who die during the early stage of the disease despite the applied therapy. This study investigates this early mortality and explores the associated risk factors. (2) Methods: We conducted a retrospective analysis of spondylodiscitis patients treated at our Level I spine center between 1 January 2018 and 31 December 2022. (3) Results: Among 430 patients, 32 (7.4%) died during their hospital stay, with a median time of 28.5 days (range: 2.0–84.0 days). Six of these patients (18.75%) did not undergo surgery due to dire clinical conditions or death prior to scheduled surgery. Identified causes of in-hospital death included multiorgan failure (<i>n</i> = 15), acute bone marrow failure (2), cardiac failure (4), liver failure (2), acute respiratory failure (2), acute renal failure (1), and concomitant oncological disease (1). In a simple logistic regression analysis, advanced age (<i>p</i> = 0.0006), diabetes mellitus (<i>p</i> = 0.0002), previous steroid medication (<i>p</i> = 0.0279), Charlson Comorbidity Index (<i>p</i> < 0.0001), and GFR level at admission (<i>p</i> = 0.0008) were significant risk factors for in-hospital death. In a multiple logistic regression analysis, advanced age (<i>p</i> = 0.0038), diabetes mellitus (<i>p</i> = 0.0002), and previous steroid medication (<i>p</i> = 0.0281) remained significant. (4) Conclusions: Despite immediate treatment, a subset of spondylodiscitis patients experience early mortality. Particular attention should be given to elderly patients and those with diabetes or a history of steroid medication, as they face an elevated risk of a rapidly progressing and fatal disease. |
| first_indexed | 2024-03-09T01:49:03Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T01:49:03Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-8da52921821a4820a56476146a3aec6b2023-12-08T15:18:42ZengMDPI AGJournal of Clinical Medicine2077-03832023-11-011223722810.3390/jcm12237228In-Hospital Mortality from Spondylodiscitis: Insights from a Single-Center Retrospective StudyAnn-Kathrin Joerger0Carolin Albrecht1Nicole Lange2Bernhard Meyer3Maria Wostrack4Department of Neurosurgery, Klinikum Rechts der Isar, Technical University Munich, 81675 Munich, GermanyDepartment of Neurosurgery, Klinikum Rechts der Isar, Technical University Munich, 81675 Munich, GermanyDepartment of Neurosurgery, Klinikum Rechts der Isar, Technical University Munich, 81675 Munich, GermanyDepartment of Neurosurgery, Klinikum Rechts der Isar, Technical University Munich, 81675 Munich, GermanyDepartment of Neurosurgery, Klinikum Rechts der Isar, Technical University Munich, 81675 Munich, Germany(1) Background: There is a marked proportion of spondylodiscitis patients who die during the early stage of the disease despite the applied therapy. This study investigates this early mortality and explores the associated risk factors. (2) Methods: We conducted a retrospective analysis of spondylodiscitis patients treated at our Level I spine center between 1 January 2018 and 31 December 2022. (3) Results: Among 430 patients, 32 (7.4%) died during their hospital stay, with a median time of 28.5 days (range: 2.0–84.0 days). Six of these patients (18.75%) did not undergo surgery due to dire clinical conditions or death prior to scheduled surgery. Identified causes of in-hospital death included multiorgan failure (<i>n</i> = 15), acute bone marrow failure (2), cardiac failure (4), liver failure (2), acute respiratory failure (2), acute renal failure (1), and concomitant oncological disease (1). In a simple logistic regression analysis, advanced age (<i>p</i> = 0.0006), diabetes mellitus (<i>p</i> = 0.0002), previous steroid medication (<i>p</i> = 0.0279), Charlson Comorbidity Index (<i>p</i> < 0.0001), and GFR level at admission (<i>p</i> = 0.0008) were significant risk factors for in-hospital death. In a multiple logistic regression analysis, advanced age (<i>p</i> = 0.0038), diabetes mellitus (<i>p</i> = 0.0002), and previous steroid medication (<i>p</i> = 0.0281) remained significant. (4) Conclusions: Despite immediate treatment, a subset of spondylodiscitis patients experience early mortality. Particular attention should be given to elderly patients and those with diabetes or a history of steroid medication, as they face an elevated risk of a rapidly progressing and fatal disease.https://www.mdpi.com/2077-0383/12/23/7228in-hospital death spondylodiscitisvertebral osteomyelitisspondylodiscitisspinal infection |
| spellingShingle | Ann-Kathrin Joerger Carolin Albrecht Nicole Lange Bernhard Meyer Maria Wostrack In-Hospital Mortality from Spondylodiscitis: Insights from a Single-Center Retrospective Study Journal of Clinical Medicine in-hospital death spondylodiscitis vertebral osteomyelitis spondylodiscitis spinal infection |
| title | In-Hospital Mortality from Spondylodiscitis: Insights from a Single-Center Retrospective Study |
| title_full | In-Hospital Mortality from Spondylodiscitis: Insights from a Single-Center Retrospective Study |
| title_fullStr | In-Hospital Mortality from Spondylodiscitis: Insights from a Single-Center Retrospective Study |
| title_full_unstemmed | In-Hospital Mortality from Spondylodiscitis: Insights from a Single-Center Retrospective Study |
| title_short | In-Hospital Mortality from Spondylodiscitis: Insights from a Single-Center Retrospective Study |
| title_sort | in hospital mortality from spondylodiscitis insights from a single center retrospective study |
| topic | in-hospital death spondylodiscitis vertebral osteomyelitis spondylodiscitis spinal infection |
| url | https://www.mdpi.com/2077-0383/12/23/7228 |
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