Vertebral osteomyelitis: long-term disability assessment and prognostic factors.
In the present study, we quantified the long-term sequelae of a series of patients diagnosed with vertebral osteomyelitis during the period 1990-2002 in Albacete (Spain), using two validated questionnaires of spinal dysfunction and also one pain and one global health assessment. It was possible to interview 69 (78%) patients diagnosed with vertebral osteomyelitis, and an additional 90 "normal" people were recruited as controls to establish normal values. We also carried out a multivariate analysis to identify independent risk factors. We found only a 33% rate of spinal disability, only 3% severe, assessed by the Oswestry and HAQ for ankylosing spondylitis questionnaires, a median of 5.4 years after treatment. Pain and global health assessment did not correlate with spinal function questionnaires. Independent predictors of long-term disability were the followings: neurological impairment at the time of diagnosis (RR=7.1, 95% CI 1.3-10.2), time to diagnosis > or = 8 weeks (RR=4.4, 95% CI 1.5-7.9) and debilitating disease (RR=3.9, 95% CI 1.2-7.5). Standardized spinal function questionnaires are useful measures to assess long-term outcome of vertebral osteomyelitis that facilitates comparison between case series and identification of risk factors.
Clinica Recoletas de Albacete, Internal Medicine, Plaza del Madrono, 11, 02006 Albacete, Spain. jesolis@ono.com
Julian
J
Solis Garcia del Pozo
Manuel
M
Vives Soto
Javier
J
Solera
D000368:Aged; D002006:Brucellosis / Q000150:complications / Q000382:microbiology / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010146:Pain; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D013131:Spine / Q000473:pathology*; D013166:Spondylitis / Q000209:etiology / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D014399:Tuberculosis, Spinal / Q000382:microbiology / Q000503:physiopathology