Mortality and health-related quality of life in patients surgically treated for spondylodiscitis

Dragsted, Casper; Aagaard, Theis; Ohrt-Nissen, Søren; Gehrchen, Martin; Dahl, Benny

doi:10.1177/2309499017716068

Cited by 23 publications

(27 citation statements)

References 28 publications

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“…VAS values for pain were significantly reduced. Our mean ODI values (T1 = 29 and T2 = 29) correspond to the retrospectively determined mean values in VO patients as reported in the literature [17]. They are above the values of Fairbank et al [22] for healthy patients and above those of Tonosu et al [23] with an age-standardized cutoff value (ODI = 22) for restrictive back pain.…”

Section: Discussionsupporting

confidence: 83%

“…High-quality studies with information regarding the effectiveness of individual therapy options are lacking, especially considering that QoL is of particular importance for evaluating success, along with functional aspects [6,20]. Even though conservative treatment is the choice for the majority of the patients, it can be estimated that 20-40% of affected patients will undergo surgery [17].…”

Section: Discussionmentioning

confidence: 99%

“…In 2017, Dragsted et al [17] first analyzed mortality and QoL using ODI and EQ-5D only in patients undergoing surgery. The 1-year mortality of 6.5% in that study is markedly less than the 1-year mortality in our study.…”

Section: Discussionmentioning

confidence: 99%

“…There have only been a few studies regarding quality of life (QoL) in VO. Available data are based mainly on retrospective analyses with small case numbers [6,[12][13][14][15][16][17][18][19]. In the first 6 months, surgically treated patients seem to have better QoL than those conservatively treated [14].…”

Section: Introductionmentioning

confidence: 99%

“…In the first 6 months, surgically treated patients seem to have better QoL than those conservatively treated [14]. Nevertheless, the QoL for VO patients is below that of the general population [6,13,17]. The goal of this study is the prospective evaluation of mortality and QoL data for VO patients surgically treated over a 2-year time period.…”

Section: Introductionmentioning

confidence: 99%

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Quality of life and mortality after surgical treatment for vertebral osteomyelitis (VO): a prospective study

et al. 2020

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Purpose Vertebral osteomyelitis (VO) has a high mortality and leads to chronic pain and functional disability. Surgical treatment is often necessary. To date, little is known about the consequences of surgery on patient outcome. The aim of this study was to determine the quality of life (QoL) and mortality rates of surgically treated VO patients for a period of 2 years. Methods Patients with VO undergoing surgical treatment in a tertiary referral hospital from 2008 to 2015 were included prospectively. Data were collected before (T0) as well as 1 year (T1) and 2 years (T2) post-surgery. Within the European Spine Tango registry, prospective patient and QoL data were collected using validated outcome scores: Oswestry Disability Index, Short Form 36/EuroQol, Visual Analog Scale, and Core Outcome Measures Index. Results From 195 patients surgically treated for VO, QoL data were available from 136 patients at T0, 100 patients at T1, and 82 patients at T2, respectively. The 1-and 2-year mortality rates were 20% and 23%. Mainly all QoL outcome scores showed significant improvement at T1 and did not change significantly from T1 to T2. Conclusion Surgical treatment of VO patients leads to significantly improved QoL. Nevertheless, QoL levels were below those of the general population. Our results underscore that spine disability questionnaires measuring QoL are mandatory to demonstrate comprehensively the severity of this entity. Our study confirms a high mortality and points out the role of VO as a potentially life-threatening condition.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Quality of life and mortality after surgical treatment for vertebral osteomyelitis (VO): a prospective study

et al. 2020

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Can we predict favourable quality of life after surgically treated vertebral osteomyelitis? Analysis of a prospective study

Yagdiran

Otto-Lambertz

Sondermann

et al. 2022

Arch Orthop Trauma Surg

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Purpose Vertebral osteomyelitis (VO) is a severe clinical entity associated with significant morbidity and mortality. Several studies have showed that successful treatment of VO patients leads to significantly improved quality of life (QoL). Nevertheless, QoL levels of these patients remained below those of the general population. There are rarely studies focusing on predicting factors for favourable QoL after surgically treated VO. The aim of this study was to identify factors influencing positively the QoL of patients undergoing surgery for VO. Methods We conducted a prospective monocentric study including surgically treated VO patients from 2008 to 2016. Data were collected before (T0) and 1 year (T1) after surgery. Primary outcome was favourable QoL defined as back pain with disability restricting normal life activity with a cutoff value ≥ 12 on Oswestry Disability Index (ODI). Ethics Ethical approval was given by the Faculty of Medicine at the University of Cologne (09-182). Results A total of 119 patients surviving 1 year after surgically treated VO were analysed. Favourable QoL was achieved in 35/119 patients. On multivariate analysis, younger age (hazard ratio = HR: 0.95; 95% CI 0.91–0.99; p = 0.022), lower albumin (HR: 0.9; 0.83–0.98; p = 0.019) an ASA score ≤ 2 (HR:4.24; 95%CI 1.42–12.68; p = 0.010), and a lower preoperative leg pain on the VAS (HR: 0.86; 95% CI 0.76–0.97; p = 0.018) were identified as independent risk factors for favourable QoL. Interestingly, the absence of neurological deficits was not predictive for a favourable outcome by means of QoL. Conclusion One-third of surgically treated VO patients (29%) in our cohort achieved favourable QoL by means of ODI. Our findings can facilitate an estimation of the prognosis when informing the patient before surgery, and underscore that spine disability questionnaires, such as ODI, measuring QoL, are mandatory to evaluate comprehensively the outcome of this entity.

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Long-term patient-related quality of life outcomes and ICD-10 symptom rating (ISR) of patients with pyogenic vertebral osteomyelitis: What is the psychological impact of this life-threatening disease?

et al. 2023

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Purpose We aimed to evaluate the long-term impact of the treatment of pyogenic vertebral osteomyelitis (VO) on functional outcomes and patients' quality of life (QoL) with a special focus on psychological well-being. Methods A total of 156 patients with VO with a minimum clinical follow-up of 12 months were retrospectively identified and asked to participate. Patient-reported outcome measures were evaluated with the EuroQol five-dimension questionnaire (EQ-5D) and German Short-Form 36 (SF-36) outcome instruments as well as with an ICD-10 based symptom rating (ISR) and compared to normative data. Spine-specific outcomes were assessed with the Core Outcome Measure Index and the Oswestry disability index (ODI) or the Neck disability index (NDI), respectively. Results From n = 156 eligible patients, n = 129 patients could be contacted and n = 40 returned questionnaires, yielding a response rate of 31.0%. The mean time from hospital discharge to follow-up was 83.0 ± 3.8 (13–193) months. Spine-specific outcomes showed mild to moderate disability. The mean physical health component score of the SF-36 (37.1 ± 16.7), the mean mental health component score (38.2 ± 14.0) and the mean EQ-5D VAS rating (57.1 ± 21.5) were significantly lower in comparison with the scores of an age-matched reference population (all p < 0.05). The mean total score of the ISR was 0.53 ± 0.23. On average, the cohort did not cross the threshold of clinically relevant symptom burden on any subscale. Conclusion Even almost seven years on average after completed treatment of VO, patients report impaired QoL. Assessment of psychological disorders should be implemented in clinical practice and future prospective studies.

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Mortality and health-related quality of life in patients surgically treated for spondylodiscitis

Cited by 23 publications

References 28 publications

Quality of life and mortality after surgical treatment for vertebral osteomyelitis (VO): a prospective study

Quality of life and mortality after surgical treatment for vertebral osteomyelitis (VO): a prospective study

Can we predict favourable quality of life after surgically treated vertebral osteomyelitis? Analysis of a prospective study

Long-term patient-related quality of life outcomes and ICD-10 symptom rating (ISR) of patients with pyogenic vertebral osteomyelitis: What is the psychological impact of this life-threatening disease?

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