Department of Orthopaedics and Trauma Surgery, University Hospital Cologne, Faculty of Medicine, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
Department I of Internal Medicine, University Hospital Cologne, Faculty of Medicine, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
Sci Rep. 2024 Nov 17;14(1):28365. doi: 10.1038/s41598-024-79828-8.
Patient-reported outcome measures for quality of life (QoL) like the Oswestry-Disability-Index (ODI) are useful for a quick, comprehensive and comparable evaluation of spondylodiscitis treatment. While it is known that even after successful surgical treatment, the QoL of spondylodiscitis patients remains below that of the general population, risk factors for a poor outcome have not been described so far. We did a retrospective post-hoc analysis of 130 surgically treated spondylodiscitis patients from 2008 to 2022. Biographical, clinical und QoL data were prospectively collected before (T) and one year (T) after surgery. The primary outcome was QoL at T. Patients were grouped according to their ODI score at T (Group 1: ODI < 35, favorable QoL; Group 2: ODI ≥ 35, poor QoL) and analyzed for risk factors present at T. Poor QoL at T occurred in 51 patients (39%). Multivariate analysis identified a higher preoperative leg pain (odds ratio: 1.2) and the presence of a malignant disease (odds ratio: 1.9) as independent preoperative risk factors for a poor QoL at T. Spondylodiscitis patients with malignancy and/or preoperative leg pain may be at increased risk for poor QoL after surgical treatment. These results can be used to individualize patient information and provide a better assessment of prognosis before surgery.
患者报告的生活质量（QoL）结果测量，如 Oswestry 功能障碍指数（ODI），可用于快速、全面和可比地评估脊柱感染的治疗效果。虽然人们已经知道，即使经过成功的手术治疗，脊柱感染患者的生活质量仍然低于一般人群，但迄今为止还没有描述导致治疗效果不佳的风险因素。我们对 2008 年至 2022 年间接受手术治疗的 130 例脊柱感染患者进行了回顾性事后分析。在手术前（T）和手术后一年（T）前瞻性收集了患者的传记、临床和 QoL 数据。主要结局是 T 时的 QoL。根据 T 时的 ODI 评分将患者分为两组（组 1：ODI<35，生活质量良好；组 2：ODI≥35，生活质量较差），并分析 T 时存在的风险因素。51 例患者（39%）T 时生活质量较差。多变量分析确定术前腿部疼痛程度较高（优势比：1.2）和存在恶性疾病（优势比：1.9）是 T 时生活质量较差的独立术前危险因素。患有恶性肿瘤和/或术前腿部疼痛的脊柱感染患者在手术后生活质量较差的风险可能增加。这些结果可用于个性化患者信息，并在手术前更好地评估预后。
