Increased short- and long-term mortality among patients with infectious spondylodiscitis compared with a reference population

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

BACKGROUND CONTEXT: Information on short- and especially long-term mortality among patients with infectious spondylodiscitis is sparse.

PURPOSE: To analyze mortality, factors associated with death, and cause-specific mortality rates among patients with infectious nonpostoperative spondylodiscitis.

STUDY DESIGN: A case-cohort study.

PATIENT SAMPLE: We identified all patients aged 18 years or older treated for infectious spondylodiscitis from January 1994 to May 2009 at hospitals in Funen County, Denmark.

OUTCOME MEASURES: Overall and cause-specific mortality.

METHODS: Mortality rates among patients were compared with rates among a reference population using Kaplan-Meier plots and mortality rate ratios (MRRs). Short-term mortality was defined as deaths within first year after admission and long-term mortality was deaths thereafter. Factors associated with death were determined.

RESULTS: Among 298 identified patients, 61 (20%) died within the first year. Adjusted MRRs were 16.8 (95% confidence interval: 9.9-28.5) for 0 to 90 days; 4.2 (2.5-7.0) for 91 to 365 days; 2.2 (1.6-2.9) for 1 to 4 years; and 1.7 (1.2-2.5) for 5 to 14 years. Mortality rate ratios stratified on microbiological etiology were 8.8 (3.3-22.1) for 0 to 90 days; 1.4 (0.3-5.8) for 91 to 365 days; 3.2 (2.0-5.1) for 1 to 4 years; and 1.1 (0.5-2.4) for 5 to 14 years for unknown etiology and 24.0 (13.0-44.2) for 0 to 90 days; 6.0 (3.1-11.5) for 91 to 365 days; 1.9 (1.1-3.2) for 1 to 4 years; and 2.7 (1.5-4.7) for 5 to 14 years among Staphylococcus aureus infections. The main factors associated with short-term mortality were severe neurologic deficits at the time of admission, epidural abscess, and comorbidities. Long-term mortality seemed independent of microbiological etiology.

CONCLUSIONS: Mortality remained high the first year after admission and thereafter decreased with time to a level close to the reference population. Short-term mortality was especially related to infection with abscess formation and neurologic deficits and long-term mortality was related to alcohol dependency.

OriginalsprogEngelsk
TidsskriftSpine Journal
Vol/bind15
Udgave nummer6
Sider (fra-til)1233-1240
ISSN1529-9430
DOI
StatusUdgivet - 19. feb. 2015

Fingeraftryk

Discitis
Population
Epidural Abscess
Denmark

Citer dette

@article{25e624c874534866b8ca50f98d73f804,
title = "Increased short- and long-term mortality among patients with infectious spondylodiscitis compared with a reference population",
abstract = "BACKGROUND CONTEXT: Information on short- and especially long-term mortality among patients with infectious spondylodiscitis is sparse.PURPOSE: To analyze mortality, factors associated with death, and cause-specific mortality rates among patients with infectious nonpostoperative spondylodiscitis.STUDY DESIGN: A case-cohort study.PATIENT SAMPLE: We identified all patients aged 18 years or older treated for infectious spondylodiscitis from January 1994 to May 2009 at hospitals in Funen County, Denmark.OUTCOME MEASURES: Overall and cause-specific mortality.METHODS: Mortality rates among patients were compared with rates among a reference population using Kaplan-Meier plots and mortality rate ratios (MRRs). Short-term mortality was defined as deaths within first year after admission and long-term mortality was deaths thereafter. Factors associated with death were determined.RESULTS: Among 298 identified patients, 61 (20{\%}) died within the first year. Adjusted MRRs were 16.8 (95{\%} confidence interval: 9.9-28.5) for 0 to 90 days; 4.2 (2.5-7.0) for 91 to 365 days; 2.2 (1.6-2.9) for 1 to 4 years; and 1.7 (1.2-2.5) for 5 to 14 years. Mortality rate ratios stratified on microbiological etiology were 8.8 (3.3-22.1) for 0 to 90 days; 1.4 (0.3-5.8) for 91 to 365 days; 3.2 (2.0-5.1) for 1 to 4 years; and 1.1 (0.5-2.4) for 5 to 14 years for unknown etiology and 24.0 (13.0-44.2) for 0 to 90 days; 6.0 (3.1-11.5) for 91 to 365 days; 1.9 (1.1-3.2) for 1 to 4 years; and 2.7 (1.5-4.7) for 5 to 14 years among Staphylococcus aureus infections. The main factors associated with short-term mortality were severe neurologic deficits at the time of admission, epidural abscess, and comorbidities. Long-term mortality seemed independent of microbiological etiology.CONCLUSIONS: Mortality remained high the first year after admission and thereafter decreased with time to a level close to the reference population. Short-term mortality was especially related to infection with abscess formation and neurologic deficits and long-term mortality was related to alcohol dependency.",
author = "Michala Kehrer and Court Pedersen and Jensen, {Th{\o}ger Gorm} and Jesper Hallas and Lassen, {Annmarie T}",
note = "Copyright {\circledC} 2015 Elsevier Inc. All rights reserved.",
year = "2015",
month = "2",
day = "19",
doi = "10.1016/j.spinee.2015.02.021",
language = "English",
volume = "15",
pages = "1233--1240",
journal = "The Spine Journal",
issn = "1529-9430",
publisher = "Elsevier",
number = "6",

}

Increased short- and long-term mortality among patients with infectious spondylodiscitis compared with a reference population. / Kehrer, Michala; Pedersen, Court; Jensen, Thøger Gorm; Hallas, Jesper; Lassen, Annmarie T.

I: Spine Journal, Bind 15, Nr. 6, 19.02.2015, s. 1233-1240.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Increased short- and long-term mortality among patients with infectious spondylodiscitis compared with a reference population

AU - Kehrer, Michala

AU - Pedersen, Court

AU - Jensen, Thøger Gorm

AU - Hallas, Jesper

AU - Lassen, Annmarie T

N1 - Copyright © 2015 Elsevier Inc. All rights reserved.

PY - 2015/2/19

Y1 - 2015/2/19

N2 - BACKGROUND CONTEXT: Information on short- and especially long-term mortality among patients with infectious spondylodiscitis is sparse.PURPOSE: To analyze mortality, factors associated with death, and cause-specific mortality rates among patients with infectious nonpostoperative spondylodiscitis.STUDY DESIGN: A case-cohort study.PATIENT SAMPLE: We identified all patients aged 18 years or older treated for infectious spondylodiscitis from January 1994 to May 2009 at hospitals in Funen County, Denmark.OUTCOME MEASURES: Overall and cause-specific mortality.METHODS: Mortality rates among patients were compared with rates among a reference population using Kaplan-Meier plots and mortality rate ratios (MRRs). Short-term mortality was defined as deaths within first year after admission and long-term mortality was deaths thereafter. Factors associated with death were determined.RESULTS: Among 298 identified patients, 61 (20%) died within the first year. Adjusted MRRs were 16.8 (95% confidence interval: 9.9-28.5) for 0 to 90 days; 4.2 (2.5-7.0) for 91 to 365 days; 2.2 (1.6-2.9) for 1 to 4 years; and 1.7 (1.2-2.5) for 5 to 14 years. Mortality rate ratios stratified on microbiological etiology were 8.8 (3.3-22.1) for 0 to 90 days; 1.4 (0.3-5.8) for 91 to 365 days; 3.2 (2.0-5.1) for 1 to 4 years; and 1.1 (0.5-2.4) for 5 to 14 years for unknown etiology and 24.0 (13.0-44.2) for 0 to 90 days; 6.0 (3.1-11.5) for 91 to 365 days; 1.9 (1.1-3.2) for 1 to 4 years; and 2.7 (1.5-4.7) for 5 to 14 years among Staphylococcus aureus infections. The main factors associated with short-term mortality were severe neurologic deficits at the time of admission, epidural abscess, and comorbidities. Long-term mortality seemed independent of microbiological etiology.CONCLUSIONS: Mortality remained high the first year after admission and thereafter decreased with time to a level close to the reference population. Short-term mortality was especially related to infection with abscess formation and neurologic deficits and long-term mortality was related to alcohol dependency.

AB - BACKGROUND CONTEXT: Information on short- and especially long-term mortality among patients with infectious spondylodiscitis is sparse.PURPOSE: To analyze mortality, factors associated with death, and cause-specific mortality rates among patients with infectious nonpostoperative spondylodiscitis.STUDY DESIGN: A case-cohort study.PATIENT SAMPLE: We identified all patients aged 18 years or older treated for infectious spondylodiscitis from January 1994 to May 2009 at hospitals in Funen County, Denmark.OUTCOME MEASURES: Overall and cause-specific mortality.METHODS: Mortality rates among patients were compared with rates among a reference population using Kaplan-Meier plots and mortality rate ratios (MRRs). Short-term mortality was defined as deaths within first year after admission and long-term mortality was deaths thereafter. Factors associated with death were determined.RESULTS: Among 298 identified patients, 61 (20%) died within the first year. Adjusted MRRs were 16.8 (95% confidence interval: 9.9-28.5) for 0 to 90 days; 4.2 (2.5-7.0) for 91 to 365 days; 2.2 (1.6-2.9) for 1 to 4 years; and 1.7 (1.2-2.5) for 5 to 14 years. Mortality rate ratios stratified on microbiological etiology were 8.8 (3.3-22.1) for 0 to 90 days; 1.4 (0.3-5.8) for 91 to 365 days; 3.2 (2.0-5.1) for 1 to 4 years; and 1.1 (0.5-2.4) for 5 to 14 years for unknown etiology and 24.0 (13.0-44.2) for 0 to 90 days; 6.0 (3.1-11.5) for 91 to 365 days; 1.9 (1.1-3.2) for 1 to 4 years; and 2.7 (1.5-4.7) for 5 to 14 years among Staphylococcus aureus infections. The main factors associated with short-term mortality were severe neurologic deficits at the time of admission, epidural abscess, and comorbidities. Long-term mortality seemed independent of microbiological etiology.CONCLUSIONS: Mortality remained high the first year after admission and thereafter decreased with time to a level close to the reference population. Short-term mortality was especially related to infection with abscess formation and neurologic deficits and long-term mortality was related to alcohol dependency.

U2 - 10.1016/j.spinee.2015.02.021

DO - 10.1016/j.spinee.2015.02.021

M3 - Journal article

C2 - 25701609

VL - 15

SP - 1233

EP - 1240

JO - The Spine Journal

JF - The Spine Journal

SN - 1529-9430

IS - 6

ER -