Open Access1418. Clinical Characteristics of Vertebral Osteomyelitis in Cancer Patients
Author(s) -
Kazuaki Fukushima,
Masao Horiuchi,
Noritaka Sekiya
Publication year - 2019
Publication title -
open forum infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.546
H-Index - 35
ISSN - 2328-8957
DOI - 10.1093/ofid/ofz360.1282
Subject(s) - medicine , vertebral osteomyelitis , osteomyelitis , cancer , medical record , lesion , retrospective cohort study , magnetic resonance imaging , vertebra , disease , surgery , radiology
Background Vertebral osteomyelitis (VOM) is an infection of vertebrae or intervertebral disc and associated with high mortality, decreased functional status, prolonged antibiotic use and recurrent infection. Although most of the patients with VOM often embody immunodeficiency or other comorbidities, characteristics of VOM in cancer patients remain to be fully elucidated. The aim of this study was to describe clinical profile, underlying disease, lesion site, pathogen, comorbidities, treatment, and outcome in patients with cancer. Methods This study was a retrospective observational study in a tertiary care cancer hospital with 801 beds. All patients with VOM were diagnosed by computed tomography or magnetic resonance imaging from July 2004 to March 2019. Culture-confirmed VOM was defined when causative pathogens were identified from the lesion site including vertebra, intervertebral disc, paravertebral or epidural abscess or when the result of blood culture was positive with compatible clinical symptoms. Data including patient characteristics, underlying diseases, lesion sites, type of infection, entry site of infection, results of bacterial culture, treatment, and outcome were collected by electronic medical records. We analyzed data of patients with culture-confirmed VOM between patients with cancer (C-VOM) and patients without cancer (NC-VOM). Death or re-treatment was the primary outcome. Statistical analysis was performed by STATA Version 15. Results Total number of patients diagnosed with VOM was 101, of which culture-confirmed VOM was 61 (C-VOM: 30 and NC-VOM: 31). Age, lesion sites, pathogen, or comorbidities were not significantly different between two groups (table). On the other hand, the rate of contiguous infection in C-VOM was significantly higher than NC-VOM (20.0 % vs. 0.0 %; P = 0.01). Univariate cox proportional hazard model revealed that cancer was risk of death or re-treatment (HR:3.14, 95% CI:1.07–9.24). Conclusion Poor prognosis and contiguous infection from adjacent infection sites should be concerned cancer patients with culture-confirmed VOM. Disclosures All authors: No reported disclosures.