A diagnostic model for differentiating tuberculous spondylitis from pyogenic spondylitis: a retrospective case–control study
Abstract The purpose of this study was to describe and compare the clinical data, laboratory examination and imaging examination of tuberculous spondylitis (TS) and pyogenic spondylitis (PS), and to provide ideas for diagnosis and treatment intervention. The patients with TS or PS diagnosed by patho...
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Nature Portfolio
2023-06-01
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Series: | Scientific Reports |
Online Access: | https://doi.org/10.1038/s41598-023-36965-w |
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author | Yu Xi Liu Fei Lei Li Peng Zheng Hao Yuan Qing Zhong Zhou Da Xiong Feng |
author_facet | Yu Xi Liu Fei Lei Li Peng Zheng Hao Yuan Qing Zhong Zhou Da Xiong Feng |
author_sort | Yu Xi Liu |
collection | DOAJ |
description | Abstract The purpose of this study was to describe and compare the clinical data, laboratory examination and imaging examination of tuberculous spondylitis (TS) and pyogenic spondylitis (PS), and to provide ideas for diagnosis and treatment intervention. The patients with TS or PS diagnosed by pathology who first occurred in our hospital from September 2018 to November 2021 were studied retrospectively. The clinical data, laboratory results and imaging findings of the two groups were analyzed and compared. The diagnostic model was constructed by binary logistic regression. In addition, an external validation group was used to verify the effectiveness of the diagnostic model. A total of 112 patients were included, including 65 cases of TS with an average age of 49 ± 15 years, 47 cases of PS with an average of 56 ± 10 years. The PS group had a significantly older age than the TS group (P = 0.005). In laboratory examination, there were significant differences in WBC, neutrophil (N), lymphocyte (L), ESR, CRP, fibrinogen (FIB), serum albumin (A) and sodium (Na). The difference was also statistically significant in the comparison of imaging examinations at epidural abscesses, paravertebral abscesses, spinal cord compression, involvement of cervical, lumbar and thoracic vertebrae. This study constructed a diagnostic model, which was Y (value of TS > 0.5, value of PS < 0.5) = 1.251 * X1 (thoracic vertebrae involved = 1, thoracic vertebrae uninvolved = 0) + 2.021 * X2 (paravertebral abscesses = 1, no paravertebral abscess = 0) + 2.432 * X3 (spinal cord compression = 1, no spinal cord compression = 0) + 0.18 * X4 (value of serum A)−4.209 * X5 (cervical vertebrae involved = 1, cervical vertebrae uninvolved = 0)−0.02 * X6 (value of ESR)−0.806 * X7 (value of FIB)−3.36. Furthermore, the diagnostic model was validated using an external validation group, indicating a certain value in diagnosing TS and PS. This study puts forward a diagnostic model for the diagnosis of TS and PS in spinal infection for the first time, which has potential guiding value in the diagnosis of them and provides a certain reference for clinical work. |
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spelling | doaj.art-f0c0ae563f1640fe96b5728e11eb816d2023-07-02T11:15:13ZengNature PortfolioScientific Reports2045-23222023-06-011311810.1038/s41598-023-36965-wA diagnostic model for differentiating tuberculous spondylitis from pyogenic spondylitis: a retrospective case–control studyYu Xi Liu0Fei Lei1Li Peng Zheng2Hao Yuan3Qing Zhong Zhou4Da Xiong Feng5Department of Orthopaedics, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopaedics, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopaedics, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopaedics, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopaedics, The Affiliated Hospital of Southwest Medical UniversityDepartment of Orthopaedics, The Affiliated Hospital of Southwest Medical UniversityAbstract The purpose of this study was to describe and compare the clinical data, laboratory examination and imaging examination of tuberculous spondylitis (TS) and pyogenic spondylitis (PS), and to provide ideas for diagnosis and treatment intervention. The patients with TS or PS diagnosed by pathology who first occurred in our hospital from September 2018 to November 2021 were studied retrospectively. The clinical data, laboratory results and imaging findings of the two groups were analyzed and compared. The diagnostic model was constructed by binary logistic regression. In addition, an external validation group was used to verify the effectiveness of the diagnostic model. A total of 112 patients were included, including 65 cases of TS with an average age of 49 ± 15 years, 47 cases of PS with an average of 56 ± 10 years. The PS group had a significantly older age than the TS group (P = 0.005). In laboratory examination, there were significant differences in WBC, neutrophil (N), lymphocyte (L), ESR, CRP, fibrinogen (FIB), serum albumin (A) and sodium (Na). The difference was also statistically significant in the comparison of imaging examinations at epidural abscesses, paravertebral abscesses, spinal cord compression, involvement of cervical, lumbar and thoracic vertebrae. This study constructed a diagnostic model, which was Y (value of TS > 0.5, value of PS < 0.5) = 1.251 * X1 (thoracic vertebrae involved = 1, thoracic vertebrae uninvolved = 0) + 2.021 * X2 (paravertebral abscesses = 1, no paravertebral abscess = 0) + 2.432 * X3 (spinal cord compression = 1, no spinal cord compression = 0) + 0.18 * X4 (value of serum A)−4.209 * X5 (cervical vertebrae involved = 1, cervical vertebrae uninvolved = 0)−0.02 * X6 (value of ESR)−0.806 * X7 (value of FIB)−3.36. Furthermore, the diagnostic model was validated using an external validation group, indicating a certain value in diagnosing TS and PS. This study puts forward a diagnostic model for the diagnosis of TS and PS in spinal infection for the first time, which has potential guiding value in the diagnosis of them and provides a certain reference for clinical work.https://doi.org/10.1038/s41598-023-36965-w |
spellingShingle | Yu Xi Liu Fei Lei Li Peng Zheng Hao Yuan Qing Zhong Zhou Da Xiong Feng A diagnostic model for differentiating tuberculous spondylitis from pyogenic spondylitis: a retrospective case–control study Scientific Reports |
title | A diagnostic model for differentiating tuberculous spondylitis from pyogenic spondylitis: a retrospective case–control study |
title_full | A diagnostic model for differentiating tuberculous spondylitis from pyogenic spondylitis: a retrospective case–control study |
title_fullStr | A diagnostic model for differentiating tuberculous spondylitis from pyogenic spondylitis: a retrospective case–control study |
title_full_unstemmed | A diagnostic model for differentiating tuberculous spondylitis from pyogenic spondylitis: a retrospective case–control study |
title_short | A diagnostic model for differentiating tuberculous spondylitis from pyogenic spondylitis: a retrospective case–control study |
title_sort | diagnostic model for differentiating tuberculous spondylitis from pyogenic spondylitis a retrospective case control study |
url | https://doi.org/10.1038/s41598-023-36965-w |
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