Morbimortality in adult patients with septic arthritis: a three-year hospital-based study

The objective of this ambispective study was to determine outcomes and associated factors for adult patients with confirmed septic arthritis (SA). All adult patients admitted to Amiens University Hospital between November 2010 and December 2013 with confirmed SA were included in the study. Patients...

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Published in:BMC infectious diseases 2016-06, Vol.16 (1), p.239-239, Article 239
Main Authors: Ferrand, Julien, El Samad, Youssef, Brunschweiler, Benoit, Grados, Franck, Dehamchia-Rehailia, Nassima, Séjourne, Alice, Schmit, Jean-Luc, Gabrion, Antoine, Fardellone, Patrice, Paccou, Julien
Format: Article
Language:English
Subjects:
Adult
Aged
Arthritis, Infectious
Arthritis, Infectious - epidemiology
Arthritis, Infectious - microbiology
Arthritis, Infectious - mortality
Arthritis, Rheumatoid - epidemiology
Arthritis, Rheumatoid - microbiology
Arthritis, Rheumatoid - mortality
Bone Diseases - epidemiology
Bone Diseases - mortality
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - mortality
Comorbidity
Diabetes Mellitus - epidemiology
Diabetes Mellitus - mortality
Female
Hospital care
Hospitals, University
Humans
Infectious arthritis
Infectious diseases
Knee Joint - microbiology
Life Sciences
Male
Middle Aged
Mortality
Musculoskeletal Diseases - epidemiology
Musculoskeletal Diseases - mortality
Patient outcomes
Retrospective Studies
Risk Factors
Staphylococcal Infections - epidemiology
Staphylococcal Infections - microbiology
Staphylococcal Infections - mortality
Staphylococcus aureus
United Kingdom
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Summary:The objective of this ambispective study was to determine outcomes and associated factors for adult patients with confirmed septic arthritis (SA). All adult patients admitted to Amiens University Hospital between November 2010 and December 2013 with confirmed SA were included in the study. Patients with prosthetic joint infections were excluded. A statistical analysis was performed in order to identify risk factors associated with a poor outcome (including mortality directly attributable to SA). A total of 109 patients (mean ± SD age: 60.1 ± 20.1; 74 male/35 females) were diagnosed with SA during the study period. The most commonly involved sites were the small joints (n = 34, 31.2 %) and the knee (n = 25, 22.9 %). The most frequent concomitant conditions were cardiovascular disease (n = 45, 41.3 %) and rheumatic disease (n = 39, 35.8 %). One hundred patients (91.7 %) had a positive microbiological culture test, with Staphylococcus aureus as the most commonly detected pathogen (n = 59, 54.1 %). Mortality directly attributable to SA was relatively infrequent (n = 6, 5.6 %) and occurred soon after the onset of SA (median [range]: 24 days [1-42]). Major risk factors associated with death directly attributable to SA were older age (p = 0.023), high C-reactive protein levels (p = 0.002), diabetes mellitus (p = 0.028), rheumatoid arthritis and other inflammatory rheumatic diseases (p = 0.021), confusion on admission (p = 0.012), bacteraemia (p = 0.015), a low creatinine clearance rate (p = 0.009) and the presence of leg ulcers/eschars (p = 0.003). The median duration of follow-up (in patients who survived for more than 6 months) was 17 months [6-43]. The proportion of poor functional outcomes was high (31.8 %). Major risk factors associated with a poor functional outcome were older age (0.049), hip joint involvement (p = 0.003), the presence of leg ulcers/eschars (p = 0.012), longer time to presentation (0.034) and a low creatinine clearance rate (p = 0.013). In a university hospital setting, SA is still associated with high morbidity and mortality rates.
ISSN:1471-2334
1471-2334
DOI:10.1186/s12879-016-1540-0