Background
Methods
Study design and patients
Measurements
Statistical analyses
Results
Patient characteristics
All | Pyogenic spondylitis | Psoas abscess | p value | |
---|---|---|---|---|
n = 126 | n = 72 | n = 54 | ||
Variables | n (%) or mean ± SD or median [IQR] | |||
Male | 69 (55) | 38 (53) | 31 (57) | 0.61 |
Age, year | 72 ± 11 | 74 ± 10 | 70 ± 11 | 0.07 |
Length of stay, days | 60 [39–97] | 60 [41–106] | 58 [36–94] | 0.06 |
In-hospital death | 11 (8.7) | 3 (4.1) | 8 (15) | 0.05 |
Invasive interventions | 54 (43) | 25 (35) | 29 (54) | 0.045 |
Percutaneous drainage | 50 (40) | 21 (29) | 29 (54) | 0.006 |
Operation | 6 (4.8) | 5 (6.9) | 1 (1.9) | 0.24 |
Laminectomy | 4 (3.2) | 4 (5.6) | 0 (0.0) | 0.13 |
Surgical drainage | 2 (1.6) | 1 (1.4) | 1 (1.9) | 1.00 |
Days after admission to diagnosis, day | 0 [0–11] | 0 [0–5] | 2 [0–20] | 0.0167 |
Days after admission to diagnosis, day ≥ 14 days | 28 (22) | 10 (14) | 18 (33) | 0.016 |
Antibiotics use, days | 28 [17–42] | 28 [18–42] | 30 [15–42] | 0.79 |
Over 6 weeks | 38 (30) | 23 (32) | 15 (28) | 0.70 |
Symptoms | ||||
Lumbago or back pain | 72 (57) | 49 (68) | 23 (43) | 0.004 |
Fever | 51 (40) | 32 (44) | 19 (35) | 0.30 |
Shock | 11 (8.7) | 2 (2.8) | 9 (17) | 0.009 |
Classification | ||||
Type A* | – | 33 (46) | – | – |
Type B* | – | 18 (25) | – | – |
Type C* | – | 21 (29) | – | – |
Multiple abscesses | – | – | 30 (56) | – |
Co-morbidities | 102 (81) | 56 (78) | 46 (85) | 0.36 |
Hospitalized for comorbidity | 57 (45) | 27 (38) | 30 (56) | 0.044 |
Hospitalized for other infections | 17 (13) | 6 (8.3) | 11 (20) | 0.07 |
Bacterial detection | 84 (67) | 45 (63) | 39 (72) | 0.34 |
Gram-positive cocci | 63 (50) | 35 (49) | 28 (52) | 0.72 |
Gram-negative rods | 19 (15) | 8 (11) | 11 (20) | 0.15 |
Mycobacterium | 2 (1.6) | 2 (2.8) | 0 (0.0) | 0.51 |
Vital signs | ||||
SBP, mmHg | 132 ± 31 | 137 ± 28 | 127 ± 35 | 0.10 |
DBP, mmHg | 75 ± 18 | 78 ± 15 | 70 ± 20 | 0.0151 |
Body temperature, °C | 37.3 ± 1.1 | 37.4 ± 1.1 | 37.2 ± 1.1 | 0.27 |
Heart rate, /min | 89 ± 19 | 88 ± 19 | 89 ± 19 | 0.30 |
Laboratory data | ||||
WBC, × 102/μL | 113 ± 51 | 106 ± 41 | 122 ± 61 | 0.07 |
Hb, g/dL | 11.3 ± 2.2 | 11.7 ± 1.8 | 10.7 ± 2.5 | 0.0116 |
Plt, × 104/μL | 22.8 ± 11.8 | 24.8 ± 11.5 | 20.0 ± 11.9 | 0.0234 |
CRP, mg/dL | 11.1 ± 9.8 | 9.4 ± 8.4 | 13.3 ± 11.0 | 0.0233 |
T-bil, mg/dL | 0.8 ± 0.5 | 0.8 ± 0.4 | 0.8 ± 0.5 | 0.75 |
Alb, g/dL | 3.3 ± 0.6 | 3.4 ± 0.6 | 3.1 ± 0.7 | 0.0045 |
AST, IU/L | 33 ± 30 | 31 ± 28 | 37 ± 31 | 0.26 |
ALT, IU/L | 26 ± 23 | 26 ± 25 | 24 ± 19 | 0.73 |
LDH, IU/L | 261 ± 123 | 239 ± 88 | 290 ± 153 | 0.0233 |
Blood sugar, mg/dL | 152 ± 71 | 141 ± 66 | 165 ± 76 | 0.06 |
BUN, mg/dL | 25.6 ± 22.8 | 20.9 ± 10.6 | 32.0 ± 32.0 | 0.0069 |
Cr, mg/dL | 1.3 ± 1.7 | 1.0 ± 0.8 | 1.7 ± 2.5 | 0.0178 |
Na, mmol/L | 137.0 ± 5.0 | 137.2 ± 5.1 | 136.7 ± 4.8 | 0.57 |
K, mmol/L | 4.0 ± 0.6 | 4.0 ± 0.5 | 3.9 ± 0.7 | 0.42 |
All | Pyogenic spondylitis | Psoas abscess | p value | |
---|---|---|---|---|
n = 126 | n = 72 | n = 54 | ||
Variables | n (%) | |||
Co-morbidities | 102 (81) | 56 (78) | 46 (85) | 0.36 |
Diabetes | 19 (15) | 10 (14) | 9 (17) | 0.80 |
Hypertension | 36 (29) | 23 (31) | 13 (24) | 0.43 |
Hyperlipidemia | 7 (5.6) | 5 (6.9) | 2 (3.7) | 0.70 |
Cardiac diseases | 18 (14) | 8 (11) | 10 (18) | 0.31 |
Cerebrovascular disease | 15 (12) | 6 (8.3) | 9 (17) | 0.17 |
Neurological disease | 15 (12) | 8 (11) | 7 (13) | 0.79 |
Dementia | 4 (3.2) | 4 (5.6) | 0 (0.0) | 0.13 |
Alcoholism | 4 (3.2) | 1 (1.4) | 3 (5.6) | 0.31 |
Neurosis | 2 (1.6) | 1 (1.4) | 1 (1.9) | 1.00 |
Schizophrenia | 2 (1.6) | 0 (0.0) | 2 (3.7) | 0.18 |
Mental retardation | 2 (1.6) | 1 (1.4) | 1 (1.9) | 1.00 |
Depression | 2 (1.6) | 1 (1.4) | 1 (1.9) | 1.00 |
Epilepsy | 1 (0.8) | 0 (0.0) | 1 (1.9) | 0.43 |
Parkinson’s disease | 1 (0.8) | 1 (1.4) | 0 (0.0) | 1.00 |
Pulmonary disease | 7 (5.6) | 3 (4.2) | 4 (7.4) | 0.46 |
Liver disease | 7 (5.6) | 4 (5.6) | 3 (5.6) | 1.00 |
Renal disease | 8 (6.3) | 3 (4.2) | 5 (9.3) | 0.29 |
Malignancy | 21 (17) | 9 (13) | 12 (22) | 0.16 |
Operation | 32 (25) | 17 (24) | 15 (28) | 0.68 |
Others | 30 (24) | 17 (24) | 13 (24) | 1.00 |
Osteoporosis | 5 (4.0) | 4 (5.6) | 1 (1.9) | 0.39 |
Pancreatitis | 2 (1.6) | 1 (1.4) | 1 (1.9) | 1.00 |
Thyroid disease | 3 (2.4) | 1 (1.4) | 2 (3.7) | 0.58 |
Inguinal hernia | 1 (0.8) | 0 (0.0) | 1 (1.9) | 0.43 |
Malignant syndrome | 1 (0.8) | 1 (1.4) | 0 (0.0) | 1.00 |
Hypoadrenalism | 1 (0.8) | 1 (1.4) | 0 (0.0) | 1.00 |
Gastrointestinal ulcer | 4 (3.2) | 2 (2.8) | 2 (3.7) | 1.00 |
Glaucoma | 3 (2.4) | 2 (2.8) | 1 (1.9) | 1.00 |
Discitis | 1 (0.8) | 1 (1.4) | 0 (0.0) | 1.00 |
Cholecystitis | 1 (0.8) | 1 (1.4) | 0 (0.0) | 1.00 |
Pemphigoid | 1 (0.8) | 1 (1.4) | 0 (0.0) | 1.00 |
Spinal stenosis | 1 (0.8) | 0 (0.0) | 1 (1.9) | 0.43 |
Rheumatoid arthritis | 1 (0.8) | 0 (0.0) | 1 (1.9) | 0.43 |
Reflux esophagitis | 2 (1.6) | 1 (1.4) | 1 (1.9) | 1.00 |
Ureteral stent placement | 1 (0.8) | 0 (0.0) | 1 (1.9) | 0.43 |
Common bile duct stone | 1 (0.8) | 1 (1.4) | 0 (0.0) | 1.00 |
Status at hospitalization | ||||
Hospitalized for comorbidity | 57 (45) | 27 (38) | 30 (56) | 0.044 |
Medical department* | 40 (32) | 19 (26) | 21 (39) | 0.18 |
Surgical department** | 17 (13) | 8 (11) | 9 (17) | 0.43 |
Hospitalized for other infections | 17 (13) | 6 (8) | 11 (20) | 0.07 |
Urinary tract infection | 7 (5.6) | 1 (1.4) | 6 (11) | 0.042 |
Sepsis | 4 (3.2) | 2 (2.8) | 2 (3.7) | 1.00 |
Pneumonia | 2 (1.6) | 0 (0.0) | 2 (3.7) | 0.19 |
Cholangitis | 1 (0.8) | 1 (1.4) | 0 (0.0) | 1.00 |
Liver abscess | 1 (0.8) | 0 (0.0) | 1 (1.9) | 0.43 |
Pulmonary tuberculosis | 1 (0.8) | 1 (1.4) | 0 (0.0) | 1.00 |
Infectious arthritis | 1 (0.8) | 1 (1.4) | 0 (0.0) | 1.00 |
Hospital courses
Death | Alive | p value | |
---|---|---|---|
(n = 11) | (n = 115) | ||
Variables | n (%) or mean ± SD or median [IQR] | ||
Male | 7 (64) | 62 (54) | 0.75 |
Age, year | 73 ± 10 | 72 ± 11 | 0.80 |
Length of stay, days | 57 [34–86] | 60 [39–98] | 0.68 |
Diseases | |||
Psoas abscess | 8 (73) | 46 (40) | 0.038 |
Invasive interventions | 6 (55) | 48 (42) | 0.31 |
Percutaneous drainage | 6 (55) | 44 (38) | 0.23 |
Operation | 1 (9.1) | 5 (4.3) | 0.43 |
Laminectomy | 0 (0.0) | 4 (3.5) | 1.00 |
Surgical drainage | 1 (9.1) | 1 (0.9) | 0.17 |
Co-morbidities | 9 (82) | 93 (81) | 1.00 |
Diabetes | 1 (9.1) | 18 (16) | 1.00 |
Hypertension | 4 (36) | 32 (28) | 0.51 |
Hyperlipidemia | 1 (9.1) | 6 (5.2) | 0.48 |
Cardiac diseases | 4 (36) | 14 (12) | 0.05 |
Cerebrovascular disease | 1 (9.1) | 14 (12) | 1.00 |
Neurological disease | 2 (18) | 13 (11) | 0.62 |
Pulmonary diseases | 0 (0.0) | 7 (6.1) | 1.00 |
Liver disease | 0 (0.0) | 7 (6.1) | 1.00 |
Renal disease | 1 (9.1) | 7 (6.1) | 0.53 |
Maligancy | 2 (18) | 19 (17) | 1.00 |
Operation | 1 (9.1) | 31 (27) | 0.29 |
Others | 2 (18) | 28 (24) | 1.00 |
Bacteria | |||
Gram-positive cocci | 7 (64) | 56 (49) | 0.53 |
Gram-negative rods | 0 (0.0) | 19 (17) | 0.21 |
Unknown | 3 (27) | 38 (33) | 1.00 |
Vital signs | |||
SBP, mmHg | 110 ± 35 | 134 ± 30 | 0.0196 |
DBP, mmHg | 62 ± 19 | 76 ± 17 | 0.0310 |
Body temperature, °C | 36.9 ± 1.1 | 37.4 ± 1.1 | 0.12 |
Heart rate, /min | 93 ± 13 | 89 ± 19 | 0.33 |
Labo data | |||
WBC, × 102/μL | 115 ± 56 | 113 ± 51 | 0.88 |
Hb, g/dL | 10.2 ± 2.8 | 11.4 ± 2.1 | 0.07 |
Plt, × 104/μL | 20.4 ± 18.8 | 23.0 ± 11.0 | 0.17 |
CRP, mg/dL | 17.8 ± 12.2 | 10.4 ± 9.3 | 0.06 |
T-bil, mg/dL | 1.1 ± 0.7 | 0.8 ± 0.5 | 0.11 |
Alb, g/dL | 2.9 ± 0.8 | 3.3 ± 0.6 | 0.0220 |
AST, IU/L | 40 ± 19 | 33 ± 31 | 0.0245 |
ALT, IU/L | 29 ± 11 | 25 ± 23 | 0.0376 |
LDH, IU/L | 327 ± 114 | 254 ± 122 | 0.0134 |
Blood sugar, mg/dL | 156 ± 42 | 151 ± 73 | 0.26 |
BUN, mg/dL | 53.5 ± 45.3 | 22.9 ± 17.5 | 0.0197 |
Cr, mg/dL | 1.7 ± 0.9 | 1.3 ± 1.8 | 0.0053 |
Na, mmol/L | 134.6 ± 10.0 | 137.3 ± 4.2 | 0.86 |
K, mmol/L | 4.0 ± 0.5 | 4.0 ± 0.6 | 0.68 |
Odds ratio | 95% confidence interval | |
---|---|---|
BUN, mg/dL | 1.04 | 1.02–1.06 |
Cardiovascular diseases | 7.02 | 1.55–31.8 |
Microbiological examinations
Bacteria | All (n = 126) |
---|---|
n (%) | |
Identified | 85 (67) |
Gram-positive cocci | 63 (50) |
Staphylococci | 51 (40) |
MSSA | 28 (22) |
MRSA | 12 (9.5) |
CNS | 11 (8.7) |
Enterococci | 3 (2.4) |
Streptococci | 8 (6.3) |
Gram-negative rods | 19 (15) |
Escherichia coli | 7 (5.6) |
Klebsiella | 3 (2.4) |
Prevotella | 3 (2.4) |
Proteus mirabilis | 2 (1.6) |
Citrobacter koseri | 1 (0.8) |
Bacteroides | 4 (3.2) |
Mycobacterium | 2 (1.6) |
Tuberculosis | 1 (0.8) |
Nontuberculosis | 1 (0.8) |
Other bacteria | 2 (1.6) |
Unknown | 41 (33) |
GNR | Others | p value | |
---|---|---|---|
(n = 19) | (n = 66) | ||
Variables | n (%) or mean ± SD or median [IQR] | ||
Male | 13 (68) | 33 (50) | 0.20 |
Age, year | 71 ± 9 | 72 ± 12 | 0.41 |
Psoas abscess | 11 (58) | 29 (44) | 0.31 |
In hospital death | 0 (0.0) | 8 (12) | 0.19 |
Invasive intervention | 11 (58) | 35 (53) | 0.80 |
Percutaneous drainage | 10 (53) | 33 (50) | 1.00 |
Operation | 2 (11) | 3 (4.5) | 0.31 |
Laminectomy | 2 (11) | 2 (3.0) | 0.22 |
Surgical drainage | 0 (0.0) | 1 (1.5) | 1.00 |
Co-morbidities | 15 (79) | 52 (79) | 1.00 |
Diabetes | 3 (16) | 9 (14) | 0.73 |
Hypertension | 5 (26) | 12 (18) | 0.52 |
Hyperlipidemia | 2 (11) | 3 (4.5) | 0.31 |
Cardiac diseases | 4 (21) | 9 (14) | 0.48 |
Cerebrovascular disease | 5 (26) | 8 (12) | 0.15 |
Neurological disease | 3 (16) | 9 (14) | 0.73 |
Pulmonary disease | 0 (0.0) | 4 (6.1) | 0.57 |
Liver disease | 1 (5.3) | 4 (6.1) | 1.00 |
Renal disease | 0 (0.0) | 4 (6.1) | 0.57 |
Malignancy | 1 (5.3) | 12 (18) | 0.28 |
Operation | 6 (32) | 17 (26) | 0.77 |
Others | 6 (32) | 12 (18) | 0.22 |
Vital signs | |||
SBP, mmHg | 124 ± 27 | 131 ± 32 | 0.40 |
DBP, mmHg | 75 ± 18 | 72 ± 16 | 0.58 |
Body tempereture, °C | 37.7 ± 1.3 | 37.4 ± 1.1 | 0.59 |
Heart rate, /min | 91 ± 17 | 91 ± 20 | 0.83 |
Laboratory | |||
WBC, ×102/μL | 138 ± 69 | 120 ± 49 | 0.42 |
Hb, g/dL | 11.8 ± 2.0 | 11.1 ± 2.1 | 0.16 |
Plt, ×104/μL | 15.8 ± 9.6 | 22.9 ± 12.3 | 0.0134 |
Plt < 1.5 × 104/μL | 11 (58) | 20 (30) | 0.034 |
CRP, mg/dL | 17.1 ± 9.5 | 12.6 ± 9.8 | 0.07 |
T-bil, mg/dL | 1.0 ± 0.6 | 0.8 ± 0.4 | 0.18 |
Alb, g/dL | 3.2 ± 0.6 | 3.2 ± 0.6 | 0.70 |
AST, IU/L | 57 ± 57 | 32 ± 23 | 0.0236 |
ALT, IU/L | 31 ± 23 | 27 ± 25 | 0.22 |
LDH, IU/L | 292 ± 126 | 264 ± 108 | 0.37 |
Blood sugar, mg/dL | 147 ± 83 | 157 ± 73 | 0.23 |
BUN, mg/dL | 26.9 ± 14.9 | 25.2 ± 20.6 | 0.19 |
Cr, mg/dL | 1.3 ± 1.2 | 1.3 ± 1.7 | 0.24 |
Na, mmol/L | 136.9 ± 3.7 | 137.0 ± 4.7 | 0.86 |
K, mmol/L | 4.0 ± 0.6 | 3.8 ± 0.5 | 0.66 |
Odds ratio | 95% confidence interval | |
---|---|---|
Plt < 1.5 × 104/μL | 3.14 | 1.02–9.65 |
AST, IU/L | 1.02 | 1.00–1.03 |