gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Does risk stratification according to the brighton spondylodiscitis score in patients with surgically treated spondylodiscitis correlate with clinical outcome?

Gibt es eine Korrelation zwischen der Risikostratifizierung nach dem Brighton Spondylodiszitis Score mit dem klinischen Ergebnis bei Patienten mit chirurgisch behandelter Spondylodisdiscitis?

Meeting Abstract

  • presenting/speaker Tatiana Chacón Quesada - Universitätsmedizin Göttingen, Neurochirurgische Klinik, Göttingen, Deutschland
  • Bawarjan Schatlo - Universitätsmedizin Göttingen, Neurochirurgische Klinik, Göttingen, Deutschland
  • Dorothee Mielke - Universitätsmedizin Göttingen, Neurochirurgische Klinik, Göttingen, Deutschland
  • Veit Rohde - Universitätsmedizin Göttingen, Neurochirurgische Klinik, Göttingen, Deutschland
  • Tammam Abboud - Universitätsmedizin Göttingen, Neurochirurgische Klinik, Göttingen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV093

doi: 10.3205/22dgnc095, urn:nbn:de:0183-22dgnc0958

Veröffentlicht: 25. Mai 2022

© 2022 Chacón Quesada et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: The prevalence of bacterial spondylodiscitis has significantly increased in the last two decades. Treatment modalities include antibiotics with or without surgical intervention with the goal of eliminating the infectious process and limiting the neurological impact, as well as ensuring a faster mobilization of the patient. The Brighton Spondylodiscitis Score (BSDS) was developed to help identify patients with spondylodiscitis who would fail non-operative management and therefore benefit from earlier surgical intervention. The goal of our study was to determine the impact of risk stratification on clinical outcome in patients with spondylodiscitis using BSDS.

Methods: We retrospectively analyzed patients with spondylodiscitis surgically treated in our institution from 2008 to 2018. BDSD was evaluated in all patients including 6 categories; distant site infection, medical comorbidity, immunocompromise, MRI characteristics, anatomical location and neurological impairment. The score ranges from 7 to 33 points. Patients were stratified in 3 groups; low risk (BDSD 7-14), moderate risk (BDSD 15-20) and high risk (BDSD 21 -33) and compared regarding length of hospital stay (LOS), neurological outcome and mortality.

Results: 206 patients were included with mean age of 70±12 years. In 74% of the cases no distant infection was detected, 11% presented with pneumonia, 4% with endocarditis and/or 17% with sepsis. 15 % were immunosuppressed at admission. The lumbosacral spine was involved in 58% of the cases and the thoracolumbar spine in 41%. 52% of the patients presented with some degree of neurological deficit, from which 7% were paraplegic. Based on the BSDS score; 59% had a low risk 29% had a moderate risk and 12% had a high risk. LOS was shorter in the low-risk group, mean of 25±15 days, followed by high and moderate risk groups; 35±22 days and 38±31 days, respectively, p=0.002. There was a trend towards the high-risk group having a higher 1-year mortality than patients with lower scores (p=0.057), however there was not significant difference between the groups in term of 30-day mortality p=0.133. No difference was found between the groups regarding neurological outcome p=0.402.

Conclusion: In patients with pyogenic spondylodiscitis, risk stratification according to BSDS might help identify patients at risk of longer hospital stay when treated surgically. However, no correlation was found between BSDS and neurological outcome or mortality.