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

TY - JOUR

T1 - Mortality and health-related quality of life in patients surgically treated for spondylodiscitis

AU - Dragsted, Casper

AU - Aagaard, Theis

AU - Ohrt-Nissen, Søren

AU - Gehrchen, Martin

AU - Dahl, Benny

PY - 2017/5

Y1 - 2017/5

N2 - Purpose: To assess mortality, disability, and health-related quality of life (HRQL) in patients surgically treated for spondylodiscitis. Methods: A retrospective longitudinal study was conducted on all patients surgically treated for spondylodiscitis over a 6-year period at a single tertiary spine center. Indications for surgery, pre-and postoperative neurological impairment, comorbidities, and mortality were recorded. A survey was conducted on all eligible patients with the EuroQol 5-dimension (EQ-5D) questionnaire and Oswestry Disability Index (ODI). Results: Sixty-five patients were diagnosed with spondylodiscitis not related to recent spine surgery. One-year mortality rate was 6%. In all, 36% and 27% had pre-and postoperative neurological impairment, respectively, with only one patient experiencing deterioration postoperatively. At final follow-up (median 2 years), mean ODI was 31% (SD = 22) and mean EQ-5D time trade-off score was 0.639 (SD = 0.262); this was significantly lower than that in the normal population (p < 0.001). Patients with neurological impairment prior to index surgery had lower EQ-5D scores (p = 0.005) and higher ODI (p = 0.02) at final follow-up compared with patients without neurological impairment. Conclusions: Several years after surgery, patients surgically treated for spondylodiscitis have significantly lower HRQL and more disability than the background population. Neurological impairment prior to index surgery predicts adverse outcome in terms of disability and lower HRQL.

AB - Purpose: To assess mortality, disability, and health-related quality of life (HRQL) in patients surgically treated for spondylodiscitis. Methods: A retrospective longitudinal study was conducted on all patients surgically treated for spondylodiscitis over a 6-year period at a single tertiary spine center. Indications for surgery, pre-and postoperative neurological impairment, comorbidities, and mortality were recorded. A survey was conducted on all eligible patients with the EuroQol 5-dimension (EQ-5D) questionnaire and Oswestry Disability Index (ODI). Results: Sixty-five patients were diagnosed with spondylodiscitis not related to recent spine surgery. One-year mortality rate was 6%. In all, 36% and 27% had pre-and postoperative neurological impairment, respectively, with only one patient experiencing deterioration postoperatively. At final follow-up (median 2 years), mean ODI was 31% (SD = 22) and mean EQ-5D time trade-off score was 0.639 (SD = 0.262); this was significantly lower than that in the normal population (p < 0.001). Patients with neurological impairment prior to index surgery had lower EQ-5D scores (p = 0.005) and higher ODI (p = 0.02) at final follow-up compared with patients without neurological impairment. Conclusions: Several years after surgery, patients surgically treated for spondylodiscitis have significantly lower HRQL and more disability than the background population. Neurological impairment prior to index surgery predicts adverse outcome in terms of disability and lower HRQL.

KW - Aged

KW - Decompression, Surgical

KW - Disability Evaluation

KW - Discitis/microbiology

KW - Female

KW - Health Care Surveys

KW - Humans

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Orthopedic Procedures

KW - Quality of Life

KW - Retrospective Studies

KW - Spine/microbiology

KW - Treatment Outcome

U2 - 10.1177/2309499017716068

DO - 10.1177/2309499017716068

M3 - Journal article

C2 - 28639530

SN - 1022-5536

VL - 25

JO - Journal of Orthopaedic Surgery

JF - Journal of Orthopaedic Surgery

IS - 2

M1 - 2309499017716068

ER -