Schindler Melanie, Huber Lorenz, Walter Nike, Straub Josina, Lang Siegmund, Szymski Dominik, Baertl Susanne, Dammerer Dietmar, Alt Volker, Rupp Markus
Division of Orthopaedics and Traumatology, University Hospital Krems, Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, Krems, 3500, Austria.
University for Continuing Education, Danube University Krems, Dr. Karl-Dorrek-Straße 30, Krems, 3500, Austria.
BMC Infect Dis. 2025 Mar 18;25(1):374. doi: 10.1186/s12879-024-10316-0.
Septic arthritis (SA) presents a complex clinical challenge, often resulting in significant morbidity and mortality. This study aimed to (1) assess overall mortality rates and (2) identify potential factors contributing to increased mortality risk in patients with SA.
This retrospective study on SA patients treated at a German university hospital between January 1, 2011, and December 31, 2021. Patients were identified using International Classification of Diseases (ICD)-10 codes for septic arthritis, specifically "M00.-". The study evaluated mortality rates and analyzed comorbidities, pathogens, and other potential risk factors. Kaplan-Meier survival curves and odds ratios (OR) were calculated to assess mortality risk.
In a cohort of 192 patients diagnosed with SA, 64 patients (33.3%) died during a mean follow-up period of 54.4 ± 42 months. The overall mortality rate was 17.5% at one year, 19.9% at two years, and 28.3% at five years. Patients aged 65 years or older, as well as those with arterial hypertension, congestive heart failure, chronic renal disease, chronic liver disease, malignancy, steroid use and immunosuppression showed significantly higher mortality rates (p < 0.05). Chronic renal disease (OR = 2.80), malignancy (OR = 3.40), and chronic heart failure (OR = 2.62) were identified as significant notably risk factors for mortality.
This study highlights a notably high mortality rate among vulnerable patients with SA, particularly those with pre-existing comorbidities. Recognizing and addressing these risk factors early could improve patient outcomes. These results unterscore the need for close monitoring of SA patients, particularly those with chronic organ conditions, and timely intervention for sepsis to reduce mortality risk.
脓毒性关节炎（SA）是一项复杂的临床挑战，常导致严重的发病率和死亡率。本研究旨在（1）评估总体死亡率，以及（2）确定导致SA患者死亡风险增加的潜在因素。
这项回顾性研究针对2011年1月1日至2021年12月31日期间在德国一家大学医院接受治疗的SA患者。使用国际疾病分类（ICD）-10编码“M00.-”来识别脓毒性关节炎患者。该研究评估了死亡率，并分析了合并症、病原体和其他潜在风险因素。计算Kaplan-Meier生存曲线和比值比（OR）以评估死亡风险。
在192例被诊断为SA的患者队列中，64例患者（33.3%）在平均54.4±42个月的随访期内死亡。一年时的总体死亡率为17.5%，两年时为19.9%，五年时为28.3%。65岁及以上的患者，以及患有动脉高血压、充血性心力衰竭、慢性肾病、慢性肝病、恶性肿瘤、使用类固醇和免疫抑制的患者，死亡率显著更高（p<0.05）。慢性肾病（OR=2.80）、恶性肿瘤（OR=3.40）和慢性心力衰竭（OR=2.62）被确定为显著的死亡风险因素。
本研究强调了SA易感患者，特别是那些已有合并症患者的显著高死亡率。早期识别和处理这些风险因素可改善患者预后。这些结果强调了密切监测SA患者的必要性，特别是那些患有慢性器官疾病的患者，并及时干预脓毒症以降低死亡风险。
