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EECONOMIC COST, DIAGNOSTIC AND PROGNOSTIC MARKERS IN IATROGENIC LUMBAR SPONDYLODISCITIS

Year 2020, Volume: 22 Issue: 3, 341 - 347, 31.12.2020
https://doi.org/10.24938/kutfd.792597

Abstract

Objective: In this study, the economic cost, diagnostic and prognostic laboratory markers of lumbar spondylodiscitis, which emerged as a complication after surgical intervention in the lumbar region, were investigated.
Material and Methods: Age and gender of the patients were recorded. Furthermore, surgical intervention type (spinal instrumentation, lumbar discectomy), biopsy results of infected tissue, concomitant morbidities, duration of hospital stay and microorganism growth in culture materials were evaluated in patients. In addition, values of serum C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), leukocyte, neutrophil and lymphocyte count which were obtained from these patients at admission to hospital and at discharge from hospital were recorded. Moreover, treatment costs of these patients were examined.
Results: Nine patients (women=7, men=2) with a mean age of 58±14.92 years were included in this study. All parameters of patients were not different in terms of surgical intervention type. However, when the patients were discharged from the hospital, their ESR and neutrophil counts decreased and lymphocyte count increased in all of them. Although CRP level values decreased as numerical value at discharge, this decrease was not statistically significant. Correlation analysis showed that length of hospital stay and tissue biopsy performed to the patients increased the economic cost.
Conclusion: It was concluded that any routine laboratory parameter investigated in this study could not be a valid biomarker for diagnosis and follow-up of spondylodiscitis that emerged after surgical intervention. On the other hand, it was concluded that diagnosis and treatment of this disease, whose prevalence is increasing, may have a high economic cost for patients and countries.

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References

  • 1. Czigléczki G, Benkő Z, Misik F, Banczerowski P. Incidence, morbidity, and surgical outcomes of complex spinal inflammatory syndromes in adults. World Neurosurg. 2017;107:63-8. Doi:10.1016/j.wneu.2017.07.096.
  • 2. Pola E, Taccari F, Autore G, Giovannenze F, Pambianco V, Cauda R et al. Multidisciplinary management of pyogenic spondylodiscitis: epidemiological and clinical features, prognostic factors and long-term outcomes in 207 patients. Eur Spine J. 2018;27(Suppl 2):229-36.
  • 3. Wang X, Tao H, Zhu Y, Lu X, Hu X. Management of postoperative spondylodiscitis with and without internal fixation. Turk Neurosurg. 2015;25(4):513-8.
  • 4. Bernard L, Dinh A, Ghout I, Simo D, Zeller V, Issartel B et al and Duration of Treatment for Spondylodiscitis (DTS) study group. Antibiotic treatment for 6 weeks versus 12 weeks in patients with pyogenic vertebral osteomyelitis: an open-label, non-inferiority, randomised, controlled trial. Lancet. 2015;385(9971):875-82.
  • 5. Noh SH, Zhang HY, Lim HS, Song HJ, Yang KH. Decompression alone versus fusion for pyogenic spondylodiscitis. Spine J. 2017;17(8):1120-6.
  • 6. Tschugg A, Lener S, Hartmann S, Rietzler A, Neururer S, Thome C. Primary acquired spondylodiscitis shows a more severe course than spondylodiscitis following spine surgery: a single-center retrospective study of 159 cases. Neurosurg Rev. 2018;41(1):141-7.
  • 7. Tschugg A, Hartmann S, Lener S, Rietzler A, Sabrina N, Thome C. Minimally invasive spine surgery in lumbar spondylodiscitis: a retrospective single-center analysis of 67 cases. Eur Spine J. 2017;26(12):3141-6.
  • 8. Sheikh AF, Khosravi AD, Goodarzi H, Nashibi R, Teimouri A, Motamedfar A et al. Pathogen identification in suspected cases of pyogenic spondylodiscitis. Front Cell Infect Microbiol. 2017;7:60. Doi:10.3389/fcimb.2017.00060.

İyatrojenik Lumbar Spondilodiskitlerde Ekonomik Maliyet, Tanısal ve Prognostik Belirteçler

Year 2020, Volume: 22 Issue: 3, 341 - 347, 31.12.2020
https://doi.org/10.24938/kutfd.792597

Abstract

Amaç: Bu çalışmada lomber bölgeye cerrahi müdahale sonrası komplikasyon olarak ortaya çıkan lomber spondilodiskitte ekonomik maliyet ile tanısal ve prognostik laboratuvar belirteçleri araştırıldı.
Gereç ve Yöntemler: Hastaların yaşı ve cinsiyeti kaydedildi. Ayrıca, cerrahi girişim tipi (spinal enstrümantasyon, lomber diskektomi), enfekte olmuş dokunun biyopsi sonuçları, eşlik eden morbiditeler, hastanede kalış süresi ve alınan kültür materyallerinde mikroorganizma üremesi değerlendirildi. Ek olarak, hastaneye yatışta ve hastaneden taburcu edildiğinde bu hastalardan elde edilen serum C-reaktif protein (CRP) seviyesi, eritrosit sedimantasyon hızı (ESH), lökosit, nötrofil ve lenfosit sayıları kaydedildi. Ayrıca, bu hastaların tedavi maliyetleri incelenmiştir.
Bulgular: Çalışmaya yaş ortalaması 58 ± 14,92 yıl olan dokuz hasta (kadın=7, erkek=2) dahil edildi. Hastaların tüm parametreleri cerrahi girişim tipi açısından farklı değildi. Ancak, tüm hastalar için, hastaneden taburcu olurken ESH ve nötrofil sayıları azalmış ve lenfosit sayıları artmıştır. CRP düzeyleri taburculuk sırasında sayısal değer olarak düşse de bu düşüş istatistiksel olarak anlamlı değildi. Korelasyon analizi, hastanede kalış süresinin ve hastalara biyopsi yapılmasıyla ekonomik maliyeti artırabileceğini göstermiştir.
Sonuç: Bu çalışmada, incelenen herhangi bir rutin laboratuvar parametresinin cerrahi girişim sonrası ortaya çıkan spondilodiskit tanısı ve takibinde geçerli bir biyobelirteç olamayacağı sonucuna varıldı. Öte yandan, prevalansı artmakta olan bu hastalığın tanı ve tedavisinin hastalar ve ülkeler için yüksek bir ekonomik maliyete sahip olabileceği sonucuna varılmıştır.

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References

  • 1. Czigléczki G, Benkő Z, Misik F, Banczerowski P. Incidence, morbidity, and surgical outcomes of complex spinal inflammatory syndromes in adults. World Neurosurg. 2017;107:63-8. Doi:10.1016/j.wneu.2017.07.096.
  • 2. Pola E, Taccari F, Autore G, Giovannenze F, Pambianco V, Cauda R et al. Multidisciplinary management of pyogenic spondylodiscitis: epidemiological and clinical features, prognostic factors and long-term outcomes in 207 patients. Eur Spine J. 2018;27(Suppl 2):229-36.
  • 3. Wang X, Tao H, Zhu Y, Lu X, Hu X. Management of postoperative spondylodiscitis with and without internal fixation. Turk Neurosurg. 2015;25(4):513-8.
  • 4. Bernard L, Dinh A, Ghout I, Simo D, Zeller V, Issartel B et al and Duration of Treatment for Spondylodiscitis (DTS) study group. Antibiotic treatment for 6 weeks versus 12 weeks in patients with pyogenic vertebral osteomyelitis: an open-label, non-inferiority, randomised, controlled trial. Lancet. 2015;385(9971):875-82.
  • 5. Noh SH, Zhang HY, Lim HS, Song HJ, Yang KH. Decompression alone versus fusion for pyogenic spondylodiscitis. Spine J. 2017;17(8):1120-6.
  • 6. Tschugg A, Lener S, Hartmann S, Rietzler A, Neururer S, Thome C. Primary acquired spondylodiscitis shows a more severe course than spondylodiscitis following spine surgery: a single-center retrospective study of 159 cases. Neurosurg Rev. 2018;41(1):141-7.
  • 7. Tschugg A, Hartmann S, Lener S, Rietzler A, Sabrina N, Thome C. Minimally invasive spine surgery in lumbar spondylodiscitis: a retrospective single-center analysis of 67 cases. Eur Spine J. 2017;26(12):3141-6.
  • 8. Sheikh AF, Khosravi AD, Goodarzi H, Nashibi R, Teimouri A, Motamedfar A et al. Pathogen identification in suspected cases of pyogenic spondylodiscitis. Front Cell Infect Microbiol. 2017;7:60. Doi:10.3389/fcimb.2017.00060.
There are 8 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Ulaş Yüksel 0000-0002-6398-4110

Mustafa Öğden 0000-0002-7129-0936

Süleyman Akkaya 0000-0003-0597-1861

Üçler Kısa 0000-0002-8131-6810

Bülent Bakar 0000-0002-6236-7647

M Faik Özveren 0000-0001-7768-1519

Project Number -
Publication Date December 31, 2020
Submission Date September 9, 2020
Published in Issue Year 2020 Volume: 22 Issue: 3

Cite

APA Yüksel, U., Öğden, M., Akkaya, S., Kısa, Ü., et al. (2020). EECONOMIC COST, DIAGNOSTIC AND PROGNOSTIC MARKERS IN IATROGENIC LUMBAR SPONDYLODISCITIS. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 22(3), 341-347. https://doi.org/10.24938/kutfd.792597
AMA Yüksel U, Öğden M, Akkaya S, Kısa Ü, Bakar B, Özveren MF. EECONOMIC COST, DIAGNOSTIC AND PROGNOSTIC MARKERS IN IATROGENIC LUMBAR SPONDYLODISCITIS. Kırıkkale Uni Med J. December 2020;22(3):341-347. doi:10.24938/kutfd.792597
Chicago Yüksel, Ulaş, Mustafa Öğden, Süleyman Akkaya, Üçler Kısa, Bülent Bakar, and M Faik Özveren. “EECONOMIC COST, DIAGNOSTIC AND PROGNOSTIC MARKERS IN IATROGENIC LUMBAR SPONDYLODISCITIS”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 22, no. 3 (December 2020): 341-47. https://doi.org/10.24938/kutfd.792597.
EndNote Yüksel U, Öğden M, Akkaya S, Kısa Ü, Bakar B, Özveren MF (December 1, 2020) EECONOMIC COST, DIAGNOSTIC AND PROGNOSTIC MARKERS IN IATROGENIC LUMBAR SPONDYLODISCITIS. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 22 3 341–347.
IEEE U. Yüksel, M. Öğden, S. Akkaya, Ü. Kısa, B. Bakar, and M. F. Özveren, “EECONOMIC COST, DIAGNOSTIC AND PROGNOSTIC MARKERS IN IATROGENIC LUMBAR SPONDYLODISCITIS”, Kırıkkale Uni Med J, vol. 22, no. 3, pp. 341–347, 2020, doi: 10.24938/kutfd.792597.
ISNAD Yüksel, Ulaş et al. “EECONOMIC COST, DIAGNOSTIC AND PROGNOSTIC MARKERS IN IATROGENIC LUMBAR SPONDYLODISCITIS”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 22/3 (December 2020), 341-347. https://doi.org/10.24938/kutfd.792597.
JAMA Yüksel U, Öğden M, Akkaya S, Kısa Ü, Bakar B, Özveren MF. EECONOMIC COST, DIAGNOSTIC AND PROGNOSTIC MARKERS IN IATROGENIC LUMBAR SPONDYLODISCITIS. Kırıkkale Uni Med J. 2020;22:341–347.
MLA Yüksel, Ulaş et al. “EECONOMIC COST, DIAGNOSTIC AND PROGNOSTIC MARKERS IN IATROGENIC LUMBAR SPONDYLODISCITIS”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, vol. 22, no. 3, 2020, pp. 341-7, doi:10.24938/kutfd.792597.
Vancouver Yüksel U, Öğden M, Akkaya S, Kısa Ü, Bakar B, Özveren MF. EECONOMIC COST, DIAGNOSTIC AND PROGNOSTIC MARKERS IN IATROGENIC LUMBAR SPONDYLODISCITIS. Kırıkkale Uni Med J. 2020;22(3):341-7.

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