From: Appropriate duration of post-surgical intravenous antibiotic therapy for pyogenic spondylodiscitis
Risk factors | No Recurrence (n = 76) | Recurrence (n = 26) | Univariate Analysis | Multivariable Analysis | ||
---|---|---|---|---|---|---|
OR (95% CI) | p value | aOR (95% CI) | p value | |||
Age, y, mean | 64 | 60 | 1.03 (0.99–1.07) | 0.12 | ||
Male sex | 46 | 19 | 1.77 (0.66–4.72) | 0.25 | ||
Underlying illness | ||||||
Alcoholism | 4 | 2 | 1.50 (0.26–8.71) | 0.64 | ||
Diabetes mellitus | 20 | 13 | 2.80 (1.11–7.05) | 0.03 | ||
Liver cirrhosis | 14 | 2 | 0.37 (0.08–1.75) | 0.35 | ||
End-stage renal disease | 11 | 8 | 2.63 (0.92–7.50) | 0.08 | ||
Intravenous drug abuser | 2 | 0 | Not calculated | |||
Malignancy | 5 | 3 | 1.85 (0.41–8.36) | 0.42 | ||
Clinical data | ||||||
Time to surgery, d, mean | 39 | 51 | 1.01 (0.99–1.02) | 0.16 | ||
Back pain | 71 | 24 | 0.99 (0.97–1.03) | 0.55 | ||
Fever | 27 | 7 | 0.67 (0.25–1.79) | 0.48 | ||
Neurologic deficit | 17 | 6 | 1.03 (0.95–1.07) | 0.39 | ||
Concurrent metastatic infection | 21 | 11 | 1.93 (0.76–4.85) | 0.22 | ||
Laboratory data (UNL) | ||||||
Abnormal WBC (11,500 cells/mL) | 25 | 11 | 1.50 (0.60–3.73) | 0.48 | ||
Abnormal ESR (30 mm/h) | 76 | 26 | Not calculated | |||
Abnormal CRP (5 mg/L) | 76 | 26 | Not calculated | |||
Positive blood culture | 18 | 14 | 3.76 (1.48–9.58) | 0.004 | 2.97 (1.13–7.91) | 0.03 |
Positive tissue culture | 55 | 22 | 2.74 (0.93–8.05) | 0.21 | ||
MRSA infection | 14 | 11 | 3.25 (1.23–8.57) | 0.02 | ||
MSSA infection | 15 | 1 | 0.16 (0.02–1.30) | 0.06 | ||
Radiographic finding | ||||||
Cervical spine infection | 3 | 0 | Not calculated | |||
Thoracic spine infection | 14 | 4 | 0.81 (0.24–2.71) | > 0.99 | ||
Lumbosacral spine infection | 61 | 22 | 1.35 (0.41–4.52) | 0.77 | ||
More than 2 levels | 15 | 5 | 0.97 (0.31–2.99) | > 0.99 | ||
Epidural abscess | 23 | 15 | 2.30 (0.93–5.73) | 0.09 | ||
Paraspinal abscess | 11 | 11 | 4.33 (1.58–11.86) | 0.003 | 3.36 (1.17–9.63) | 0.02 |
Treatment data | ||||||
Anterior surgery | 22 | 7 | 0.90 (0.33–2.45) | > 0.99 | ||
Posterior surgery | 30 | 12 | 1.31 (0.54–3.23) | 0.65 | ||
A + P surgery | 24 | 7 | 0.80 (0.30–2.15) | 0.81 | ||
Instrumentation | 39 | 9 | 0.50 (0.20–1.27) | 0.18 | ||
Duration of pre-op antibiotics, d | 10.2 | 8.4 | 1.00 (0.96–1.03) | 0.84 |