1414. Time-to-Completed-Imaging, Survival, and Function in Patients with Spinal Epidural Abscess: Description of a Series of 34 Patients, 2015–2018

BACKGROUND: Spinal epidural abscess (SEA) is a rare and life-threatening infection with increased incidence over the past two decades. Delays in diagnosis cause significant morbidity and mortality among patients. The objective of this study was to describe average time-to-imaging and frequencies of intervention, risk factors, and outcomes among patients with SEA presenting to an emergency department at a single academic health center in Portland, Oregon. METHODS: This retrospective cohort study reviewed data from patients with no prior history of SEAs at a single hospital from October 1, 2015 to April 1, 2018. We report measures of central tendency and frequencies of collected information. RESULTS: Of the 34 patients included, seven (20%) died or were discharged with plegia during the study period. Four others (11.8%) had motor weakness, and four (11.8%) patients had new bowel or bladder dysfunction at discharge. Those who died or were discharged with plegia (n = 7) had shorter mean time-to-imaging order (20.8 hours vs. 29.2 hours). Patients with a history of intravenous drug use had a longer mean time-to-imaging order (30.2 hours vs. 23.7 hours) vs. those without a history of intravenous drug use. Furthermore, only three (42.9%) of the seven patients who died or acquired plegia presented with the three symptom classic triad of SEA: (1) fever; (2) abnormal neurologic examination or symptoms; and (3) neck or back pain. CONCLUSION: SEA is a potentially deadly infection requiring prompt identification and treatment. This research provides baseline data for potential quality improvement work at the study site. Future research should evaluate multi-center approaches for identifying and intervening to treat SEA, particularly among patients with a history of intravenous drug use. [Image: see text] [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.