Abstract
BackgroundPsoas 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.MethodsAll 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.ResultsWe 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.ConclusionsPatients with suspected psoas abscesses or pyogenic spondylitis having a high BUN level and a history of cardiovascular diseases have a higher risk of mortality.
Highlights
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
Because clinical characteristics and risk factors associated with mortality or bacterial strains have not been well investigated, we described the clinical characteristics of patients with pyogenic spondylitis and psoas abscesses and investigated the factors associated with in-hospital deaths and the presence
Lumbago or back pain was more frequent in pyogenic spondylitis (49 [68%] vs. 23 [43%], p = 0.004), whereas shock was more frequent in psoas abscesses (9 [17%] vs. 2 [2.8%], p = 0.009) (Table 1)
Summary
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. 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. Patients often have underlying diseases such as malignancies, diabetes mellitus, chronic renal failure, and cirrhosis, as well as long-term corticosteroid use [4,5,6,7,8]. These diseases are diagnosed using a combination of imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI) and specimen cultures; diagnosis may often be difficult if the patient has few symptoms. Because clinical characteristics and risk factors associated with mortality or bacterial strains have not been well investigated, we described the clinical characteristics of patients with pyogenic spondylitis and psoas abscesses and investigated the factors associated with in-hospital deaths and the presence
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