RESUMEN
STUDY DESIGN: Retrospective study. OBJECTIVE: To study the clinical outcomes of patients suffering from pyogenic spinal infections (PSI), by comparing the outcomes of patients with an identified microbiological agent with those of patients without an identified pathogen. SUMMARY OF BACKGROUND DATA: PSI is associated with significant risks for morbidity and mortality. Specific antibiotic treatment has been considered a key to successful medical treatment; however, clinicians frequently treat patients with PSI without an identified agent. A paucity of data is available comparing the clinical outcomes of patients with or without an identified pathogen. MATERIALS AND METHODS: The records of 97 consecutive patients discharged from a University Hospital with the diagnosis of PSI during a 14-year period were retrospectively reviewed. Patients' demographics, etiological agent, comorbidities, site of infection, white blood cell count, erythrocyte sedimentation rate, C-reactive protein at the time of presentation, neurological impairment, length of hospital stay, and mortality were registered to compare the clinical outcomes of patients with an identified pathogen with those of patients without an identified agent. RESULTS: The causative organism was identified in 74 patients (76.3%). Patients with microbiological diagnosis were younger, and a larger percentage of them exhibited elevated C-reactive protein value; however, they were not different from those without an identified agent in terms of sex, site of infection, comorbidities, and the presence of a concomitant infection. Our study could not demonstrate different neurological outcomes, length of stay, or mortality rates among the 2 groups. CONCLUSIONS: In a large series of patients with PSI, we did not demonstrate differences in clinical outcomes using empirical antibiotics in patients without an identified pathogen compared with patients with an identified microbiological agent receiving specific antibiotics. Future prospective multicenter studies should be conducted to obtain an answer to this important clinical question.
Asunto(s)
Antibacterianos/uso terapéutico , Enfermedades de la Columna Vertebral/tratamiento farmacológico , Enfermedades de la Columna Vertebral/microbiología , Adulto , Factores de Edad , Anciano , Sedimentación Sanguínea , Proteína C-Reactiva/metabolismo , Femenino , Humanos , Tiempo de Internación , Recuento de Leucocitos , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso/etiología , Osteomielitis/tratamiento farmacológico , Osteomielitis/microbiología , Reacción en Cadena de la Polimerasa , Estudios Prospectivos , Estudios Retrospectivos , Factores Sexuales , Enfermedades de la Columna Vertebral/mortalidad , Resultado del TratamientoRESUMEN
Chronic spinal diseases, including deformities and muscular pain, are significant causes of morbidity among adults and the elderly. The scope of this study is to assess the life expectancy of Brazilians with chronic spinal diseases by sex and age between 2003 and 2008. The Sullivan method was used, combining the mortality/actuarial table with the prevalence of chronic spinal diseases. The mortality/actuarial tables published by the Brazilian Institute of Geography and Statistics (IBGE) were used and the prevalence of chronic spinal diseases was taken from the Brazilian Household Sample Survey (PNAD) for the years under scrutiny. The main results indicate that a man born in Brazil in 2008 could expect to live for 69.1 years, of which 15% with chronic spinal diseases. However, women born in the same year had a life expectancy of 76.7 years and could expect to live a fifth of their lives with chronic spinal diseases. Over the period under analysis, concurrently with gains in life expectancy, there was an increase in healthy life expectancy, or length of life lived without chronic spinal diseases, both in absolute and relative terms.
Asunto(s)
Esperanza de Vida , Enfermedades de la Columna Vertebral/mortalidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Niño , Preescolar , Enfermedad Crónica , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
As doenças crônicas de coluna, entre elas as deformidades e as dores musculares, são importantes causas de morbidade entre adultos e idosos. O objetivo deste estudo foi estimar a expectativa de vida de brasileiros com doenças crônicas de coluna, por sexo e idade, nos anos de 2003 e 2008. Empregou-se o método de Sullivan, combinando a tábua de vida e as prevalências de doen ças crônicas de coluna. Foram utilizadas as tá buas de vida publicadas pelo Instituto Brasileiro de Geografia e Estatística e as prevalências de enfermidades crônicas de coluna da Pesquisa Nacio nal por Amostra Domiciliar (PNAD), dos anos selecionados. Os principais resultados indicam que, no Brasil, ao nascer em 2008, um homem poderia esperar viver 69,1 anos, 15% dos quais com doenças crônicas de coluna. Já as mulheres que nasceram neste mesmo ano, apresentavam uma expectativa de vida de 76,7 anos e espera riam viver um quinto de sua vida com problemas crônicos de coluna. No período analisado, concomitantemente aos ganhos na expectativa de vida, ocorreu um crescimento na expectativa de vida saudável, ou seja, nos anos de vida livre de doenças crônicas da coluna, tanto em termos absolutos como relativos.
Chronic spinal diseases, including deformities and muscular pain, are significant causes of morbidity among adults and the elderly. The scope of this study is to assess the life expectancy of Brazilians with chronic spinal diseases by sex and age between 2003 and 2008. The Sullivan method was used, combining the mortality/actuarial table with the prevalence of chronic spinal diseases. The mortality/actuarial tables published by the Brazilian Institute of Geography and Statistics (IBGE) were used and the prevalence of chronic spinal diseases was taken from the Brazilian Household Sample Survey (PNAD) for the years under scrutiny. The main results indicate that a man born in Brazil in 2008 could expect to live for 69.1 years, of which 15% with chronic spinal diseases. However, women born in the same year had a life expectancy of 76.7 years and could expect to live a fifth of their lives with chronic spinal diseases. Over the period under analysis, concurrently with gains in life expectancy, there was an increase in healthy life expectancy, or length of life lived without chronic spinal diseases, both in absolute and relative terms.