Morbimortality in adult patients with septic arthritis: a three-year hospital-based study

Abstract

BackgroundThe objective of this ambispective study was to determine outcomes and associated factors for adult patients with confirmed septic arthritis (SA).MethodsAll adult patients admitted to Amiens University Hospital between November 2010 and December 2013 with confirmed SA were included in the study. Patients with prosthetic joint infections were excluded. A statistical analysis was performed in order to identify risk factors associated with a poor outcome (including mortality directly attributable to SA).ResultsA total of 109 patients (mean ± SD age: 60.1 ± 20.1; 74 male/35 females) were diagnosed with SA during the study period. The most commonly involved sites were the small joints (n = 34, 31.2 %) and the knee (n = 25, 22.9 %). The most frequent concomitant conditions were cardiovascular disease (n = 45, 41.3 %) and rheumatic disease (n = 39, 35.8 %). One hundred patients (91.7 %) had a positive microbiological culture test, with Staphylococcus aureus as the most commonly detected pathogen (n = 59, 54.1 %). Mortality directly attributable to SA was relatively infrequent (n = 6, 5.6 %) and occurred soon after the onset of SA (median [range]: 24 days [1–42]). Major risk factors associated with death directly attributable to SA were older age (p = 0.023), high C-reactive protein levels (p = 0.002), diabetes mellitus (p = 0.028), rheumatoid arthritis and other inflammatory rheumatic diseases (p = 0.021), confusion on admission (p = 0.012), bacteraemia (p = 0.015), a low creatinine clearance rate (p = 0.009) and the presence of leg ulcers/eschars (p = 0.003). The median duration of follow-up (in patients who survived for more than 6 months) was 17 months [6–43]. The proportion of poor functional outcomes was high (31.8 %). Major risk factors associated with a poor functional outcome were older age (0.049), hip joint involvement (p = 0.003), the presence of leg ulcers/eschars (p = 0.012), longer time to presentation (0.034) and a low creatinine clearance rate (p = 0.013).ConclusionsIn a university hospital setting, SA is still associated with high morbidity and mortality rates.

Mortality and adverse joint outcomes following septic arthritis of the native knee: a longitudinal cohort study of patients receiving arthroscopic washout

“…1,2 Rates of mortality as high as 10-15%, [3][4][5][6][7][8] osteomyelitis in 8%, 8 and a subjective poor outcome in 20-30% of cases have been reported. 3,6,[8][9][10] The true rate of adverse outcomes has remained uncertain as previous studies have had a number of limitations, such as heterogenous inclusion criteria and inconsistent reporting of outcomes. No study has been joint specific and most studies included patients with small joint infection, prior surgery or joint arthroplasty, and outcomes were reported at inconsistent periods of follow up.…”

Bilateral septic arthritis of the knee caused by group B streptococci: a case report

“…Staphylococcus aureus remains the top etiologic cause of SA (2). The attributed morbidity and mortality is substantial; treatment is of critical benefit to avert consequences (3). Culture-based diagnosis is not helpful in a proportion of patients, hence early antibacterial treatment to prevent permanent joint damage remains a challenge (1,3).…”

The Immunomodulatory Effect of Trichophyton Rubrum Exoantigens in the Treatment of Experimental Septic Arthritis

“…Some studies have reported data on the incidence of SA in the Western Europe and USA, which respectively have been between 2 and 10 per 100,000 patient-years [2]. …”