1128. Factors for neurologic sequelae in patients with hematogenous vertebral osteomyelitis
Session: Poster Abstract Session: Clinical Infectious Diseases: Bone and Joint, Skin and Soft Tissue
Friday, October 28, 2016
Room: Poster Hall
Background: Neurologic impairment may be persistent in patients with hematogenous vertebral osteomyelitis (HVO). However, predictors of residual neurologic sequelae in HVO remain uncertain. The objective of this study was to evaluate the factors for neurologic sequelae in HVO. 

Methods: We conducted a retrospective study of all cases of HVO between January 2005 and December 2015, occurring in 5 tertiary-care hospitals in the Republic of Korea. Neurologic sequelae include new paresis necessitating wheelchair-use and/or bladder/bowel incontinence that persisted for at least 12 months after completing the treatment.

Results: A total of 324 patients with microbiologically diagnosed HVO were recruited. Of these, 277 patients were included in the analysis, excluding 47 patients died within 1 year after diagnosis. Of these 277 patients, 50 (18.1%) patients had neurologic sequelae at 1 year after completing the treatment. Neurologic deficit at diagnosis were found in 13 (32.0%) patients with neurologic sequelae, and 28 (12.3%) patients without neurologic sequelae (P <0.001). Neurologic deficit at diagnosis (adjusted odds ratio [aOR], 4.24; 95% confidence interval [CI], 1.89-9.50), old age (≥ 65 years) (aOR, 3.80; 95% CI, 1.75-8.26), undrained paraverterbal/psoas abscess (aOR, 3.36; 95% CI, 1.50-7.51) , relapse of HVO within 1 year (aOR, 2.63; 95% CI, 1.03-6.68), and Staphylococcus aureus HVO (aOR, 2.16; 95% CI, 1.03-4.52) were independent risk factors for neurologic sequelae in patients with HVO.

Conclusion: Our data suggest that drainage of paravertebral/psoas abscess and adequate antimicrobial and surgical therapy in preventing relapse of HVO may be beneficial for improving neurologic outcome in patients with HVO. 

Yu-Mi Lee, MD1, Hyun Jung Park, MD2, Ki-Ho Park, MD3, Oh-Hyun Cho, MD4, Seong Yeon Park, MD5, Chisook Moon, MD1, Sung-Han Kim, MD6, Sang-Oh Lee, MD6, Sang-Ho Choi, MD6, In-Gyu Bae, MD4, Yang Soo Kim, MD6, Jun Hee Woo, MD6 and Mi Suk Lee, MD, PhD3, (1)Department of Infectious Diseases, Busan Paik Hospital, Busan, South Korea, (2)Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea, (3)Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Seoul, South Korea, (4)Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea, (5)Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea, The Republic of, (6)Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, The Republic of

Disclosures:

Y. M. Lee, None

H. J. Park, None

K. H. Park, None

O. H. Cho, None

S. Y. Park, None

C. Moon, None

S. H. Kim, None

S. O. Lee, None

S. H. Choi, None

I. G. Bae, None

Y. S. Kim, None

J. H. Woo, None

M. S. Lee, None

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