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Epidemiology and Outcomes of Infectious Spondylodiscitis in Hemodialysis Patients.

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eMediNexus    29 January 2018

The goal of a new study published in Spine was to elucidate the epidemiology and prognostic factors of infectious spondylodiscitis in hemodialysis (HD) patients, and to identify the impact of HD on infectious spondylodiscitis. This retrospective review included 1,402 patients who were hospitalized for infectious spondylodiscitis over a 13 year period; 102 patients on maintenance HD were enrolled in this study. The participants had an average age 63.3 ± 11.2 years and a male-to-female ratio of 1:1.04. The findings revealed that back pain was present in 75.5% of patients, while the most commonly infected site was lumbosacral spine. Infection associated with vascular access was identified in 31.4% of patients. The prevalence of dialysis via central venous catheters was higher than prevalent HD patients. On the other hand, methicillin-resistant S. aureus was the most common pathogen, followed by coagulase-negative staphylococci. The patients in-hospital survival rate was 82.4%; their vascular access survival rate was 75.5%; their one-year survival rate was 78.4%; and their one-year recurrence rate was 20.2%. Congestive heart failure was associated with an increased one-year mortality. Whereas, other variables exhibited no significant relationship with patients in-hospital mortality, one-year mortality or recurrence. Hence, it was inferred that most of the demographic and clinical variables, evaluated upon admission, did not predict mortality or recurrence in HD patients.

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