Abstract
Background Chronic osteomyelitis is characterized by changes in bone structure of different extent and severity that are poorly defined. The objective was to determine the incidence of sepsis in patients with non-specific osteomyelitis of the spine (NOS) and tuberculous spondylitis (TS), and compare the main risk factors contributing to the occurrence. Material and methods Treatment was produced for 82 patients with verified sepsis that accounted for 8.6 % of all patients operated for infectious spondylitis (IS). Patients were diagnosed with NOS (n = 48, Group 1) and TS (n = 34, Group 2). Microflora in the blood was detected in half (n = 39, 47.5 %) of the patients with procalcitonin test performed in all cases. Results IS patients were diagnosed with chronic pulmonary diseases (45/58.0 %), renal diseases (32/39.0%), chronic stomach and duodenal diseases (23/28.0 %), viral hepatitis (18/21.9 %), cardiovascular diseases (23/28.0 %), diabetes mellitus (12/14.6 %), etc. Factors contributing to the development of sepsis in TS patients were chronic pulmonary diseases (p = 0.024, χ2 = 7.132), liver cirrhosis (p = 0.036, χ2 = 6.458) and HIV (p = 0.035, χ2 = 6.158). Discussion Risk factors for septic conditions in IS patients included age over 70 years, severe neurological deficit, hypoalbuminemia, cachexia (BMI < 17 kg/m2), obesity (BMI > 35 kg/m2), HIV and severe comorbidities (ASA 3 or ASA 4). The favorable outcome of the disease occurred due to early detection of sepsis based on SOFA score and timely initiated pathogenetic treatment.
Highlights
Sepsis is a recognized global health challenge and associated with high morbidity and mortality [1, 2]
The objective was to determine the incidence of sepsis in patients with non-specific osteomyelitis of the spine (NOS) and tuberculous spondylitis (TS), and compare the main risk factors contributing to the occurrence
Sepsis was detected in 82 cases of our series that accounted for 8.6 % of all operated infectious spondylitis (IS) patients
Summary
Sepsis is a recognized global health challenge and associated with high morbidity and mortality [1, 2]. Surgical treatment of infectious spondylitis (IS) is associated with the risk of postoperative complications that range between 6 % and 30 % [7–9] and can be classified as early, delayed and late infections [10]. The objective was to determine the incidence of sepsis in patients with non-specific osteomyelitis of the spine (NOS) and tuberculous spondylitis (TS), and compare the main risk factors contributing to the occurrence. Factors contributing to the development of sepsis in TS patients were chronic pulmonary diseases (p = 0.024, χ2 = 7.132), liver cirrhosis (p = 0.036, χ2 = 6.458) and HIV (p = 0.035, χ2 = 6.158). Discussion Risk factors for septic conditions in IS patients included age over 70 years, severe neurological deficit, hypoalbuminemia, cachexia (BMI < 17 kg/m2), obesity (BMI > 35 kg/m2), HIV and severe comorbidities (ASA 3 or ASA 4). Keyword: infectious spondylitis, non-specific osteomyelitis of spine, tuberculous spondylitis, HIV, risk factors
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