Native vertebral osteomyelitis in aged patients: distinctive features. An observational cohort study

Purpose To describe the demographic, clinical, and microbiological profile of native vertebral osteomyelitis (NVO) in aged patients as compared to that of younger patients, to identify differences that could motivate changes in clinical management. Methods Retrospective, observational cohort study (1990–2015) including all adult patients with microbiologically confirmed NVO divided into 2 groups: aged (≥ 65 years) vs younger (18–64 years). Results 247 patients included, 138 aged and 109 younger. Relative to younger patients, the aged had higher rates of healthcare-related infection (40.6 vs 25.7%, p = 0.014), previous known heart valve disease (29.7 vs 9.2%, p < 0.001), and concomitant infective endocarditis (38.4 vs 20.2%, p = 0.002). The groups showed similar rates of symptomatic spinal cord compression (14.5 vs 11.9%, p = 0.556) and paraspinal abscesses (62.3 vs 68.8%, p = 0.288) at presentation. There was a trend to lower spine surgery rates in the aged (11.6 vs 17.4%, p = 0.192). On univariate analysis, Staphylococcus aureus infection was associated with higher in-hospital mortality in aged (29%, OR 4.3, 95% CI 1.61–11.45). In-hospital mortality was higher among the aged (14.5 vs 6.4%, p = 0.044) as well as relapse rate due to treatment failure (3.4 vs 1%, p = 0.377). Conclusions The findings underscore the importance of preventing healthcare-related infection and maintaining high clinical suspicion of infective endocarditis in aged NVO patients to implement proper management. S. aureus infection had a poorer prognosis in this population. As compared to younger patients, spinal surgery rates were slightly lower and overall prognosis poorer in the aged, despite similar rates of symptomatic spinal cord compression and abscesses at presentation..

Medienart:

E-Artikel

Erscheinungsjahr:

2018

Erschienen:

2018

Enthalten in:

Zur Gesamtaufnahme - volume:46

Enthalten in:

Infection - 46(2018), 5 vom: 12. Juli, Seite 679-686

Sprache:

Englisch

Beteiligte Personen:

Aguilar-Company, Juan [VerfasserIn]
Pigrau, Carles [VerfasserIn]
Fernández-Hidalgo, Nuria [VerfasserIn]
Rodríguez-Pardo, Dolors [VerfasserIn]
Falcó, Vicenç [VerfasserIn]
Lung, Mayli [VerfasserIn]
Pellisé, Ferran [VerfasserIn]
Almirante, Benito [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

Aged
Bone infections
Healthcare-related infection
Infective endocarditis
Native vertebral osteomyelitis

Anmerkungen:

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

doi:

10.1007/s15010-018-1177-6

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2104725399

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