In-Hospital Mortality from Spondylodiscitis: Insights from a Single-Center Retrospective Study

(1) Background: There is a marked proportion of spondylodiscitis patients who die during the early stage of the disease despite the applied therapy. This study investigates this early mortality and explores the associated risk factors. (2) Methods: We conducted a retrospective analysis of spondylodi...

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Bibliographic Details
Published in:Journal of clinical medicine 2023-11, Vol.12 (23), p.7228
Main Authors: Joerger, Ann-Kathrin, Albrecht, Carolin, Lange, Nicole, Meyer, Bernhard, Wostrack, Maria
Format: Article
Language:English
Subjects:
Antibiotics
Biopsy
Body mass index
Care and treatment
Clinical medicine
Comorbidity
Diabetes
Disease
Hospital patients
Hospitals
Infections
Inflammation
Intervertebral disk
Magnetic resonance imaging
Medical personnel
Mortality
Regression analysis
Risk factors
Sepsis
Steroids
Substance abuse treatment
Surgery
Tomography
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Summary:(1) Background: There is a marked proportion of spondylodiscitis patients who die during the early stage of the disease despite the applied therapy. This study investigates this early mortality and explores the associated risk factors. (2) Methods: We conducted a retrospective analysis of spondylodiscitis patients treated at our Level I spine center between 1 January 2018 and 31 December 2022. (3) Results: Among 430 patients, 32 (7.4%) died during their hospital stay, with a median time of 28.5 days (range: 2.0-84.0 days). Six of these patients (18.75%) did not undergo surgery due to dire clinical conditions or death prior to scheduled surgery. Identified causes of in-hospital death included multiorgan failure ( = 15), acute bone marrow failure (2), cardiac failure (4), liver failure (2), acute respiratory failure (2), acute renal failure (1), and concomitant oncological disease (1). In a simple logistic regression analysis, advanced age ( = 0.0006), diabetes mellitus ( = 0.0002), previous steroid medication ( = 0.0279), Charlson Comorbidity Index ( < 0.0001), and GFR level at admission ( = 0.0008) were significant risk factors for in-hospital death. In a multiple logistic regression analysis, advanced age ( = 0.0038), diabetes mellitus ( = 0.0002), and previous steroid medication ( = 0.0281) remained significant. (4) Conclusions: Despite immediate treatment, a subset of spondylodiscitis patients experience early mortality. Particular attention should be given to elderly patients and those with diabetes or a history of steroid medication, as they face an elevated risk of a rapidly progressing and fatal disease.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm12237228