Clinical characteristics of pyogenic spondylitis and psoas abscess at a tertiary care hospital: a retrospective cohort study
Abstract Background Psoas abscess and pyogenic spondylitis are intractable diseases that require long-term treatment, but the clinical characteristics and causative organisms have not been fully investigated. Herein, we describe the clinical characteristics of these diseases and evaluate the factors...
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doaj-516b54969bed465b99f0315b596348cc2020-11-25T02:17:59ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2018-11-011311910.1186/s13018-018-1005-9Clinical characteristics of pyogenic spondylitis and psoas abscess at a tertiary care hospital: a retrospective cohort studyTsukasa Nakamura0Takeshi Morimoto1Kosuke Katsube2Yuji Yamamori3Junji Mashino4Kiyoshi Kikuchi5Department of Infectious Diseases, Shimane Prefectural Central HospitalClinical Education and Research Center, Shimane Prefectural Central HospitalDepartment of Orthopedics, Shimane Prefectural Central HospitalDepartment of Emergency Medicine, Shimane Prefectural Central HospitalClinical Education and Research Center, Shimane Prefectural Central HospitalDepartment of Pediatrics, Shimane Prefectural Central HospitalAbstract Background Psoas abscess and pyogenic spondylitis are intractable diseases that require long-term treatment, but the clinical characteristics and causative organisms have not been fully investigated. Herein, we describe the clinical characteristics of these diseases and evaluate the factors associated with in-hospital mortality and the presence of gram-negative rods as causative microorganisms. Methods All patients diagnosed with pyogenic spondylitis or psoas abscesses at a tertiary hospital were included. We retrieved the clinical data (age, sex, outcome, length of hospital stay, disease, bacteria, medication, comorbidities, and treatment status), vital signs (blood pressure, heart rate, and body temperature), and laboratory test results (blood cell count, liver function, renal function, electrolytes, blood sugar, and C-reactive protein) of all patients. The outcomes were in-hospital deaths and positive cultures of gram-negative rods. Results We analyzed 126 patients consisting of 69 (55%) men with a population mean age of 72 years. Seventy-two patients had pyogenic spondylitis and 54 had psoas abscesses. Eleven patients (8.3%) died during admission. The causative bacteria were gram-positive cocci in 63 patients (50%) and gram-negative bacteria in 19 patients (15%). The multivariate logistic model showed that blood urea nitrogen (BUN) (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.02–1.06) and cardiovascular diseases (OR 7.02, 95% CI 1.55–31.8) were associated with in-hospital mortality. Platelets less than 150,000/μL (OR 3.14, 95% CI 1.02–9.65) and higher aspartic aminotransferase (OR 1.02, 95% CI 1.00–1.03) were associated with gram-negative rods. Conclusions Patients with suspected psoas abscesses or pyogenic spondylitis having a high BUN level and a history of cardiovascular diseases have a higher risk of mortality.http://link.springer.com/article/10.1186/s13018-018-1005-9Pyogenic spondylitisPsoas abscessMortality |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tsukasa Nakamura Takeshi Morimoto Kosuke Katsube Yuji Yamamori Junji Mashino Kiyoshi Kikuchi |
spellingShingle |
Tsukasa Nakamura Takeshi Morimoto Kosuke Katsube Yuji Yamamori Junji Mashino Kiyoshi Kikuchi Clinical characteristics of pyogenic spondylitis and psoas abscess at a tertiary care hospital: a retrospective cohort study Journal of Orthopaedic Surgery and Research Pyogenic spondylitis Psoas abscess Mortality |
author_facet |
Tsukasa Nakamura Takeshi Morimoto Kosuke Katsube Yuji Yamamori Junji Mashino Kiyoshi Kikuchi |
author_sort |
Tsukasa Nakamura |
title |
Clinical characteristics of pyogenic spondylitis and psoas abscess at a tertiary care hospital: a retrospective cohort study |
title_short |
Clinical characteristics of pyogenic spondylitis and psoas abscess at a tertiary care hospital: a retrospective cohort study |
title_full |
Clinical characteristics of pyogenic spondylitis and psoas abscess at a tertiary care hospital: a retrospective cohort study |
title_fullStr |
Clinical characteristics of pyogenic spondylitis and psoas abscess at a tertiary care hospital: a retrospective cohort study |
title_full_unstemmed |
Clinical characteristics of pyogenic spondylitis and psoas abscess at a tertiary care hospital: a retrospective cohort study |
title_sort |
clinical characteristics of pyogenic spondylitis and psoas abscess at a tertiary care hospital: a retrospective cohort study |
publisher |
BMC |
series |
Journal of Orthopaedic Surgery and Research |
issn |
1749-799X |
publishDate |
2018-11-01 |
description |
Abstract Background Psoas abscess and pyogenic spondylitis are intractable diseases that require long-term treatment, but the clinical characteristics and causative organisms have not been fully investigated. Herein, we describe the clinical characteristics of these diseases and evaluate the factors associated with in-hospital mortality and the presence of gram-negative rods as causative microorganisms. Methods All patients diagnosed with pyogenic spondylitis or psoas abscesses at a tertiary hospital were included. We retrieved the clinical data (age, sex, outcome, length of hospital stay, disease, bacteria, medication, comorbidities, and treatment status), vital signs (blood pressure, heart rate, and body temperature), and laboratory test results (blood cell count, liver function, renal function, electrolytes, blood sugar, and C-reactive protein) of all patients. The outcomes were in-hospital deaths and positive cultures of gram-negative rods. Results We analyzed 126 patients consisting of 69 (55%) men with a population mean age of 72 years. Seventy-two patients had pyogenic spondylitis and 54 had psoas abscesses. Eleven patients (8.3%) died during admission. The causative bacteria were gram-positive cocci in 63 patients (50%) and gram-negative bacteria in 19 patients (15%). The multivariate logistic model showed that blood urea nitrogen (BUN) (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.02–1.06) and cardiovascular diseases (OR 7.02, 95% CI 1.55–31.8) were associated with in-hospital mortality. Platelets less than 150,000/μL (OR 3.14, 95% CI 1.02–9.65) and higher aspartic aminotransferase (OR 1.02, 95% CI 1.00–1.03) were associated with gram-negative rods. Conclusions Patients with suspected psoas abscesses or pyogenic spondylitis having a high BUN level and a history of cardiovascular diseases have a higher risk of mortality. |
topic |
Pyogenic spondylitis Psoas abscess Mortality |
url |
http://link.springer.com/article/10.1186/s13018-018-1005-9 |
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