The Burden of Vertebral Osteomyelitis—An Analysis of the Workforce before and after Treatment
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Selection
2.2. Data Collection
2.3. Assessment of ATW
- Not satisfied with treatment results after VO treatment.
- Slightly satisfied with treatment results after VO treatment.
- Moderately satisfied with treatment results after VO treatment.
- Fully satisfied with treatment results after VO treatment.
2.4. Definition of Endpoints
2.5. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Patients’ Satisfaction
3.3. Workforce
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Nickerson, E.K.; Sinha, R. Vertebral osteomyelitis in adults: An update. Br. Med. Bull. 2016, 117, 121–138. [Google Scholar] [CrossRef] [PubMed]
- Kehrer, M.; Pedersen, C.; Jensen, T.G.; Hallas, J.; Lassen, A.T. Increased short- and long-term mortality among patients with in-fectious spondylodiscitis compared with a reference population. Spine J. 2015, 15, 1233–1240. [Google Scholar] [CrossRef] [PubMed]
- Herren, C.; Jung, N.; Pishnamaz, M.; Breuninger, M.; Siewe, J.; Sobottke, R. Spondylodiscitis: Diagnosis and Treatment Options. Dtsch. Ärzteblatt Int. 2017, 114, 875–882. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Aagaard, T.; Roed, C.; Dahl, B.; Obel, N. Long-term prognosis and causes of death after spondylodiscitis: A Danish nationwide cohort study. Infect. Dis. 2016, 48, 201–208. [Google Scholar] [CrossRef] [PubMed]
- Aagaard, T.; Roed, C.; Larsen, A.R.; Petersen, A.; Dahl, B.; Skinhøj, P.; Obel, N.; Danish Staphylococcal Bacteraemia Study Group. Long-term mortality after Staphylococcus aureus spondylodiscitis: A Danish nationwide population-based cohort study. J. Infect. 2014, 69, 252–258. [Google Scholar] [CrossRef] [PubMed]
- Yagdiran, A.; Otto-Lambertz, C.; Lingscheid, K.M.; Sircar, K.; Samel, C.; Scheyerer, M.J.; Zarghooni, K.; Eysel, P.; Sobottke, R.; Jung, N.; et al. Quality of life and mortality after surgical treatment for vertebral osteomyelitis (VO): A prospective study. Eur. Spine J. 2021, 30, 1721–1731. [Google Scholar] [CrossRef] [PubMed]
- Pola, E.; Taccari, F.; Autore, G.; Giovannenze, F.; Pambianco, V.; Cauda, R.; Maccauro, G.; Fantoni, M. Multidisciplinary management of pyogenic spondylodiscitis: Epidemiological and clinical features, prognostic factors and long-term outcomes in 207 patients. Eur. Spine J. 2018, 27, 229–236. [Google Scholar] [CrossRef] [PubMed]
- Gupta, A.; Kowalski, T.J.; Osmon, D.R.; Enzler, M.J.; Steckelberg, J.M.; Huddleston, P.; Nassr, A.; Mandrekar, J.M.; Berbari, E.F. Long-Term Outcome of Pyogenic Vertebral Osteomyelitis: A Cohort Study of 260 Patients. Open Forum Infect. Dis. 2014, 1, ofu107. [Google Scholar] [CrossRef] [Green Version]
- Sobottke, R.; Röllinghoff, M.; Zarghooni, K.; Zarghooni, K.; Schlüter-Brust, K.; Delank, K.-S.; Seifert, H.; Zweig, T.; Eysel, P. Spondylodiscitis in the elderly patient: Clinical mid-term results and quality of life. Arch. Orthop. Trauma. Surg. 2009, 130, 1083–1091. [Google Scholar] [CrossRef] [PubMed]
- Rutges, J.P.H.J.; Kempen, D.; Van Dijk, M.; Oner, F.C. Outcome of conservative and surgical treatment of pyogenic spondylodiscitis: A systematic literature review. Eur. Spine J. 2016, 25, 983–999. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Dragsted, C.; Aagaard, T.; Ohrt-Nissen, S.; Gehrchen, M.; Dahl, B. Mortality and health-related quality of life in patients surgically treated for spondylodiscitis. J. Orthop. Surg. 2017, 25, 2309499017716068. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- O’Daly, B.J.; Morris, S.F.; O’Rourke, S.K. Long-term Functional Outcome in Pyogenic Spinal Infection. Spine 2008, 33, E246–E253. [Google Scholar] [CrossRef] [PubMed]
- Kehrer, M.; Hallas, J.; Bælum, J.; Jensen, T.G.; Pedersen, C.; Lassen, A.T. Reduced ability to work both before and after infectious spondylodiscitis in working-age patients. Infect. Dis. 2016, 49, 1–9. [Google Scholar] [CrossRef] [PubMed]
- Lee, Y.-M.; Cho, O.-H.; Park, S.Y.; Moon, C.; Chong, Y.P.; Kim, S.-H.; Lee, S.-O.; Choi, S.-H.; Lee, M.S.; Bae, I.-G.; et al. Factors associated with sequelae after treatment of hematogenous pyogenic vertebral osteomyelitis. Diagn. Microbiol. Infect. Dis. 2019, 94, 66–72. [Google Scholar] [CrossRef]
- Diagnostik und Therapie der Spondylodiszitis—S2k-Leitlinie. Available online: https://www.awmf.org/uploads/tx_szleitlinien/151-001l_S2k_Diagnostik-Therapie-Spondylodiszitis_2020-10.pdf (accessed on 6 January 2022).
- Jung, N.; Ernst, A.; Joost, I.; Yagdiran, A.; Peyerl-Hoffmann, G.; Grau, S.; Breuninger, M.; Hellmich, M.; Kubosch, D.; Klingler, J.; et al. Vertebral osteomyelitis in patients with Staphylococcus aureus bloodstream infection: Evaluation of risk factors for treatment failure. J. Infect. 2021, 83, 314–320. [Google Scholar] [CrossRef]
- Breuninger, M.; Yagdiran, A.; Willinger, A.; Biehl, L.M.; Otto-Lambertz, C.; Kuhr, K.; Seifert, H.; Fätkenheuer, G.; Lehmann, C.; Sobottke, R.; et al. Vertebral Osteomyelitis after Spine Surgery: A Disease with Distinct Characteristics. Spine 2020, 45, 1426–1434. [Google Scholar] [CrossRef]
- Niedziela, J.; Hudzik, B.; Niedziela, N.; Gąsior, M.; Gierlotka, M.; Wasilewski, J.; Myrda, K.; Lekston, A.; Poloński, L.; Rozentryt, P. The obesity paradox in acute coronary syndrome: A meta-analysis. Eur. J. Epidemiol. 2014, 29, 801–812. [Google Scholar] [CrossRef] [PubMed]
- Ni, Y.-N.; Luo, J.; Yu, H.; Wang, Y.-W.; Hu, Y.-H.; Liu, D.; Liang, B.-M.; Liang, Z.-A. Can body mass index predict clinical outcomes for patients with acute lung injury/acute respiratory distress syndrome? A meta-analysis. Crit. Care 2017, 21, 1–10. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Wang, S.; Liu, X.; Chen, Q.; Liu, C.; Huang, C.; Fang, X. The role of increased body mass index in outcomes of sepsis: A systematic review and meta-analysis. BMC Anesthesiol. 2017, 17, 1–11. [Google Scholar] [CrossRef]
- Disability and Work. The Picture We Learn from Official Statistics. Available online: https://nda.ie/nda-files/disability-and-work-the-picture-we-learn-from-official-statistics.pdf (accessed on 6 January 2022).
- Rehabilitation and Return-to-Work Polices and Systems in European Countries. Available online: https://oshwiki.eu/wiki/Rehabilitation_and_return-to-work_polices_and_systems_in_European_Countries (accessed on 6 January 2022).
All VO Patients 18–≤63 (n = 114) | VO Patients at Work T0 (n = 52, 19%) | VO Patients at Work T1 (n = 30, 58%) | VO Patients Not at Work T1 (n = 22, 42%) | p-Value * | |
---|---|---|---|---|---|
Age (years) Median (interquartile range) | 55 [48; 59] | 55 [48; 59] | 55 [48; 58] | 56 [47; 61] | 0.373 |
Male n (%) | 83 (73) | 42 (81) | 24 (80) | 18 (82) | 0.869 |
BMI n (%) | 98 (86) | 45 (87) | 24 (80) | 21 (95) | 0.023 * |
Underweight | 7 (7) | 2 (4) | 0 (0) | 2 (10) | |
Normal | 31 (32) | 11 (24) | 4 (17) | 7 (33) | |
Overweight | 28 (29) | 18 (40) | 14 (58) | 4 (19) | |
Obese | 32 (33) | 14 (31) | 6 (25) | 8 (38) | |
CCI Median (interquartile range) | 2 [1; 3] | 1 [1; 2] | 1 [0; 2] | 2 [1; 3] | 0.055 |
Underlying Comorbidities | |||||
Diabetes n (%) | 22 (19) | 8 (15) | 5 (17) | 3 (14) | 0.764 |
Malignancy n (%) | 18 (16) | 5 (10) | 4 (13) | 1 (5) | 0.268 |
Rheumatic disease n (%) | 9 (8) | 3 (6) | 0 (0) | 3 (14) | 0.020 * |
Cardiac insufficiency n (%) | 6 (5) | 1 (2) | 0 (0) | 1 (5) | 0.186 |
Chronic kidney disease n (%) | 11 (10) | 2 (4) | 0 (0) | 2 (9) | 0.060 |
Alcohol abuse n (%) | 14 (12) | 4 (8) | 2 (7) | 2 (9) | 0.747 |
Drug abuse n (%) | 11 (10) | 3 (6) | 1 (3) | 2 (9) | 0.381 |
Number of comorbidities | 0.007 * | ||||
0 n (%) | 42 (37) | 31 (60) | 18 (60) | 13 (59) | |
1 n (%) | 34 (30) | 13 (25) | 11 (37) | 2 (9) | |
≥2 n (%) | 38 (33) | 8 (15) | 1 (3) | 7 (32) | |
ASA | 106 (93) | 49 (94) | 27 (30) | 22 (100) | |
1 n (%) | 9 (8) | 6 (12) | 4 (15) | 2 (9) | |
2 n (%) | 40 (38) | 28 (57) | 17 (63) | 11 (50) | |
>3 n (%) | 57 (54) | 15 (31) | 6 (22) | 9 (41) | |
Bacteremia n (%) | 35 (31) | 15 (29) | 9 (30) | 6 (27) | 0.830 |
Pathogen detected n (%) | 89 (78) | 40 (77) | 23 (77) | 17 (77) | 0.414 |
S. aureus | 37 (32) | 19 (37) | 10 (33) | 9 (41) | |
CNS | 20 (18) | 10 (19) | 4 (13) | 6 (27) | |
GN | 7 (6) | 1 (2) | 1 (3) | 0 (0) | |
Enterococcus species | 7 (6) | 1 (2) | 1 (3) | 0 (0) | |
Mycobacteria | 4 (4) | 2 (4) | 1 (3) | 1 (5) | |
Proprionibacterium species | 3 (3) | 2 (4) | 2 (7) | 0 (0) | |
Anaerobes | 3 (3) | 2 (4) | 1 (3) | 1 (5) | |
Streptococcus species | 3 (3) | 1 (2) | 1 (3) | 0 (0) | |
Candida species | 2 (2) | 1 (2) | 1 (3) | 1 (5) | |
Corynebacterium species | 1 (1) | 1 (2) | 1 (3) | 0 (0) | |
ID Consultation n (%) | 99 (87) | 46 (89) | 25 (83) | 21 (96) | 0.155 |
Manifestations n (%) | |||||
Endocarditis | 5 (4) | 1 (2) | 0 (0) | 1 (5) | 0.186 |
Psoas Abscess | 20 (18) | 7 (13) | 4 (13) | 3 (14) | 0.975 |
Empyema | 44 (39) | 22 (42) | 13 (43) | 9 (41) | 0.861 |
Spinal level | 0.405 | ||||
Cervical n (%) | 5 (4) | 2 (4) | 1 (3) | 1 (5) | 0.823 |
Thoracic n (%) | 26 (23) | 11 (21) | 4 (13) | 7 (32) | 0.108 |
Lumbar n (%) | 76 (67) | 37 (71) | 24 (80) | 13 (59) | 0.100 |
Multilevel n (%) | 7 (6) | 2 (4) | 1 (3) | 1 (5) | 0.823 |
Segments affected | 0.167 | ||||
1 n (%) | 89 (78) | 42 (81) | 26 (87) | 16 (73) | |
>1 n (%) | 25 (22) | 10 (19) | 4 (13) | 6 (27) | |
Neurological Deficit (Frankel) n (%) | 25 (22) | 6 (12) | 2 (7) | 4 (18) | 0.201 |
A | 3 (3) | 0 (0) | 0 (0) | 0 (0) | |
B | 3 (3) | 1 (2) | 0 (0) | 1 (5) | |
C | 10 (9) | 3 (6) | 1 (3) | 2 (9) | |
D | 9 (8) | 2 (4) | 1 (3) | 1 (5) | |
E | 89 (78) | 46 (88) | 28 (93) | 18 (82) | |
Vertebral Destruction (Eysel/Peters) n (%) | 0.423 | ||||
1 | 13 (11) | 9 (17) | 5 (17) | 4 (18) | |
2 | 64 (56) | 35 (67) | 22 (73) | 13 (59) | |
3 | 35 (31) | 8 (15) | 3 (10) | 5 (23) | |
Surgical Treatment n (%) | 99 (87) | 45 (87) | 24 (80) | 21 (96) | 0.087 |
Recurrent disease n (%) | 11 (10) | 6 (12) | 3 (10) | 3 (14) | 0.687 |
Physical work (at T0) | 0.120 | ||||
Heavy n (%) | 29 (56) | 14 (47) | 15 (68) | ||
Light n (%) | 23 (44) | 16 (53) | 7 (32) | ||
Treatment Satisfaction (at T1) | 0.020 * | ||||
1 n (%) | 4 (8) | 0 (0) | 4 (18) | ||
2 n (%) | 9 (17) | 5 (17) | 4 (18) | ||
3 n (%) | 11 (21) | 5 (17) | 6 (27) | ||
4 n (%) | 28 (54) | 20 (67) | 8 (36) |
Patients at T0 n (%) | Patients at T1 n (%) | |
---|---|---|
at work | 52 (100) | 30 (58) |
not at work | 0 (0) | 22 (42) |
Disability pension | 0 (0) | 13 (25) |
Heavy physical work | 29 (56) | 12 (23) |
Light physical work | 23 (44) | 18 (35) |
Full-time (100%) | 38 (73) | 16 (31) |
Part-time (75–≤100%) | 8 (15) | 4 (8) |
Part-time (50%) | 4 (7) | 3 (6) |
Part-time (<50%) Retraining Sick leave | 2 (4) n.a. n.a. | 1 (2) 5 (10) 9 (17) |
Patients BMI < 25 at T0 n(%) | Patients BMI > 25 at T0 n(%) | p-Value | |
---|---|---|---|
Heavy physical work | 9 (75) | 17 (52) | 0.158 |
Light physical work | 3 (25) | 16 (48) |
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Yagdiran, A.; Bredow, J.; Weber, C.; Mousa Basha, G.; Eysel, P.; Fischer, J.; Jung, N. The Burden of Vertebral Osteomyelitis—An Analysis of the Workforce before and after Treatment. J. Clin. Med. 2022, 11, 1095. https://doi.org/10.3390/jcm11041095
Yagdiran A, Bredow J, Weber C, Mousa Basha G, Eysel P, Fischer J, Jung N. The Burden of Vertebral Osteomyelitis—An Analysis of the Workforce before and after Treatment. Journal of Clinical Medicine. 2022; 11(4):1095. https://doi.org/10.3390/jcm11041095
Chicago/Turabian StyleYagdiran, Ayla, Jan Bredow, Carolyn Weber, Ghaith Mousa Basha, Peer Eysel, Julia Fischer, and Norma Jung. 2022. "The Burden of Vertebral Osteomyelitis—An Analysis of the Workforce before and after Treatment" Journal of Clinical Medicine 11, no. 4: 1095. https://doi.org/10.3390/jcm11041095
APA StyleYagdiran, A., Bredow, J., Weber, C., Mousa Basha, G., Eysel, P., Fischer, J., & Jung, N. (2022). The Burden of Vertebral Osteomyelitis—An Analysis of the Workforce before and after Treatment. Journal of Clinical Medicine, 11(4), 1095. https://doi.org/10.3390/jcm11041095