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Recurrence Rates and Its Associated Factors after Early Spinal Instrumentation for Pyogenic Spondylodiscitis: A Nationwide Cohort Study of 2148 Patients

Recent studies have consistently reported the safety and effectiveness of early spinal instrumentation for pyogenic spondylodiscitis. However, none of these studies investigated the recurrence rate or associated factors based on this specific group of patients. Recurrence prediction models that are...

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Autores principales: Lim, Jeong Seop, Kim, Tae-Hwan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225581/
https://www.ncbi.nlm.nih.gov/pubmed/35743427
http://dx.doi.org/10.3390/jcm11123356
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author Lim, Jeong Seop
Kim, Tae-Hwan
author_facet Lim, Jeong Seop
Kim, Tae-Hwan
author_sort Lim, Jeong Seop
collection PubMed
description Recent studies have consistently reported the safety and effectiveness of early spinal instrumentation for pyogenic spondylodiscitis. However, none of these studies investigated the recurrence rate or associated factors based on this specific group of patients. Recurrence prediction models that are not based on a homogenous cohort of patients undergoing early spinal instrumentation show theoretical limitations for clinical use. A nationwide, population-based, retrospective cohort study using a claims database was planned to investigate the recurrence rate and its associated factors in patients who underwent early instrumented spinal fusion surgery for pyogenic spondylodiscitis. We used data from the Korean National Health Insurance claims database collected between 2014 and 2018. A total of 2148 patients who underwent early (within 6 weeks after the diagnosis) instrumented spinal fusion surgery for pyogenic spondylodiscitis were included, including 1925 patients (90%) without recurrence and 223 patients (10%) with recurrence. Logistic regression models were used to identify factors associated with recurrence, and sensitivity analysis was performed according to two different definitions for recurrence: shorter (2 weeks or more) and longer (6 weeks or more) periods of antibiotic therapy for recurrence. The recurrence rates in our cohort were 14.1%, 10.4%, and 8.0% at 2, 4, and 6 weeks, respectively, in relation to the duration of antibiotic treatment for recurrence. We identified age 60–69 years (OR = 2.42), age > 70 years (OR = 2.29), posterior thoracic approach (OR = 1.85), multiple surgical approaches (OR = 4.17), use of a cage (OR = 1.66), transfusion (OR = 2.55), antibiotics for resistant organisms (OR = 2.55), and systemic steroid treatment over 2 weeks (OR = 2.27) as the factors associated with recurrence. The recurrence rates and associated factors from our first population-based and the largest clinical study can be practically used as a reasonable reference and provide clinicians with an acceptable tool for the comprehensive risk assessment for recurrence after early spinal instrumentation for pyogenic spondylodiscitis.
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spelling pubmed-92255812022-06-24 Recurrence Rates and Its Associated Factors after Early Spinal Instrumentation for Pyogenic Spondylodiscitis: A Nationwide Cohort Study of 2148 Patients Lim, Jeong Seop Kim, Tae-Hwan J Clin Med Article Recent studies have consistently reported the safety and effectiveness of early spinal instrumentation for pyogenic spondylodiscitis. However, none of these studies investigated the recurrence rate or associated factors based on this specific group of patients. Recurrence prediction models that are not based on a homogenous cohort of patients undergoing early spinal instrumentation show theoretical limitations for clinical use. A nationwide, population-based, retrospective cohort study using a claims database was planned to investigate the recurrence rate and its associated factors in patients who underwent early instrumented spinal fusion surgery for pyogenic spondylodiscitis. We used data from the Korean National Health Insurance claims database collected between 2014 and 2018. A total of 2148 patients who underwent early (within 6 weeks after the diagnosis) instrumented spinal fusion surgery for pyogenic spondylodiscitis were included, including 1925 patients (90%) without recurrence and 223 patients (10%) with recurrence. Logistic regression models were used to identify factors associated with recurrence, and sensitivity analysis was performed according to two different definitions for recurrence: shorter (2 weeks or more) and longer (6 weeks or more) periods of antibiotic therapy for recurrence. The recurrence rates in our cohort were 14.1%, 10.4%, and 8.0% at 2, 4, and 6 weeks, respectively, in relation to the duration of antibiotic treatment for recurrence. We identified age 60–69 years (OR = 2.42), age > 70 years (OR = 2.29), posterior thoracic approach (OR = 1.85), multiple surgical approaches (OR = 4.17), use of a cage (OR = 1.66), transfusion (OR = 2.55), antibiotics for resistant organisms (OR = 2.55), and systemic steroid treatment over 2 weeks (OR = 2.27) as the factors associated with recurrence. The recurrence rates and associated factors from our first population-based and the largest clinical study can be practically used as a reasonable reference and provide clinicians with an acceptable tool for the comprehensive risk assessment for recurrence after early spinal instrumentation for pyogenic spondylodiscitis. MDPI 2022-06-11 /pmc/articles/PMC9225581/ /pubmed/35743427 http://dx.doi.org/10.3390/jcm11123356 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lim, Jeong Seop
Kim, Tae-Hwan
Recurrence Rates and Its Associated Factors after Early Spinal Instrumentation for Pyogenic Spondylodiscitis: A Nationwide Cohort Study of 2148 Patients
title Recurrence Rates and Its Associated Factors after Early Spinal Instrumentation for Pyogenic Spondylodiscitis: A Nationwide Cohort Study of 2148 Patients
title_full Recurrence Rates and Its Associated Factors after Early Spinal Instrumentation for Pyogenic Spondylodiscitis: A Nationwide Cohort Study of 2148 Patients
title_fullStr Recurrence Rates and Its Associated Factors after Early Spinal Instrumentation for Pyogenic Spondylodiscitis: A Nationwide Cohort Study of 2148 Patients
title_full_unstemmed Recurrence Rates and Its Associated Factors after Early Spinal Instrumentation for Pyogenic Spondylodiscitis: A Nationwide Cohort Study of 2148 Patients
title_short Recurrence Rates and Its Associated Factors after Early Spinal Instrumentation for Pyogenic Spondylodiscitis: A Nationwide Cohort Study of 2148 Patients
title_sort recurrence rates and its associated factors after early spinal instrumentation for pyogenic spondylodiscitis: a nationwide cohort study of 2148 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225581/
https://www.ncbi.nlm.nih.gov/pubmed/35743427
http://dx.doi.org/10.3390/jcm11123356
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