Prognostic factors associated with mortality in patients with septic arthritis: a descriptive cohort study.
OBJECTIVE
To evaluate the 30-day mortality rate of septic arthritis (SA) in adults in Funen, central Denmark, and to explore whether, at the time of SA presentation, risk factors for the 30-day mortality rate could be revealed. Our secondary objective was to describe the microbiological aetiologies, systemic signs of inflammation, and co-morbidity.


METHODS
A descriptive study identifying patients with SA from central Denmark, during the period 2006-2013, by the use of joint fluid culture data retrieved from the electronic database at the Department of Clinical Microbiology, Odense University Hospital. Patients with a positive joint fluid culture were considered eligible and their medical records were examined.


RESULTS
We identified 215 patients with SA, mean age 64.8 years. At presentation, mean C-reactive protein (CRP) was 204 mg/L, mean white blood cell count (WBC) 11.9 × 109/L, and mean body temperature 37.6°C. A total of 101 patients (47%) had a prosthetic joint, 46 (21%) had an inflammatory joint disease, and 24 (11%) had diabetes mellitus (DM). Staphylococcus aureus was the most common pathogen (104 patients, 48.4%). The 30-day mortality rate was 9.3% and the significant risk factor for death was liver disease at time of presentation [odds ratio (OR) 40.40, 95% confidence interval (CI) 5.38-303]. The other factors tested such as age > 65 years, elevated temperature, rheumatoid arthritis (RA), prostheses, and diabetes mellitus (DM) did not reach statistical significance.


CONCLUSIONS
In our sample of patients with SA, we found a 30-day mortality rate in almost one in 10 adults. Among possible explanations, our study indicates that liver disease is a clinically relevant risk factor.
a Department of Medicine , Svendborg Hospital, Odense University Hospital , Svendborg , Denmark.
R A
RA
Andreasen
b Research Department of Clinical Microbiology, Faculty of Health Science , University of Southern Denmark , Odense , Denmark.
N S
NS
Andersen
a Department of Medicine , Svendborg Hospital, Odense University Hospital , Svendborg , Denmark.
S A
SA
Just
c Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology , Bispebjerg and Frederiksberg Hospitals , Frederiksberg , Denmark.
R
R
Christensen
a Department of Medicine , Svendborg Hospital, Odense University Hospital , Svendborg , Denmark.
Imj
I
Hansen
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors
D000900:Anti-Bacterial Agents