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Lookup NU author(s): Dr John Widdrington, Ingrid Emmerson, Dr Edmund OngORCiD, Dr Matthias Schmid, Dr David Price, Dr Ulrich Schwab, Dr Christopher DuncanORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
We aimed to describe the clinical features and outcomes of pyogenic spondylodiscitis and to identify factors associated with an unfavourable clinical outcome (defined as death, permanent disability, spinal instability or persistent pain). In our tertiary centre, 91 cases were identified prospectively and a retrospective descriptive analysis of clinical records was performed prior to binary regression analysis of factors associated with an unfavourable outcome. A median 26 days elapsed from the onset of symptoms to diagnosis and 51% of patients had neurological impairment at presentation. A microbiological diagnosis was reached in 81%, with Staphylococcus aureus most commonly isolated. Treatment involved prolonged hospitalisation (median stay 40.5 days), long courses of antibiotics (>6 weeks in 98%) and surgery in 42%. While this was successful in eradicating infection, only 32% of patients had a favourable clinical outcome and six patients (7%) died. Diabetes mellitus, clinical evidence of neurological impairment at presentation, a longer duration of symptoms and radiological evidence of spinal cord or cauda equina compression were independent factors associated with an unfavourable outcome. Our data indicate that spondylodiscitis is associated with significant morbidity and suggest that adverse outcomes may be predicted to an extent by factors present at the time of diagnosis.
Author(s): Widdrington JD, Emmerson I, Cullinan M, Narayanan M, Klejnow E, Watson A, Ong ELC, Schmid ML, Price DA, Schwab U, Duncan CJA
Publication type: Article
Publication status: Published
Journal: Medical Sciences
Year: 2018
Volume: 6
Issue: 4
Pages: 96
Print publication date: 30/10/2018
Online publication date: 30/10/2018
Acceptance date: 23/10/2018
Date deposited: 05/03/2019
ISSN (electronic): 2076-3271
Publisher: MDPI
URL: https://doi.org/10.3390/medsci6040096
DOI: 10.3390/medsci6040096
PubMed id: 30380776
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