Incidence and risk factors for mortality of vertebral osteomyelitis: a retrospective analysis using the Japanese diagnosis procedure combination database
Objective To examine the incidence of vertebral osteomyelitis (VO) and the clinical features of VO focusing on risk factors for death using a Japanese nationwide administrative database.Design Retrospective observational study.Setting Hospitals adopting the Diagnosis Procedure Combination system dur...
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BMJ Publishing Group
2013-03-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/3/3/e002412.full |
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| author | Hideo Yasunaga Hirotaka Chikuda Kiyohide Fushimi Hiromasa Horiguchi Toru Akiyama Kazuo Saita |
| author_facet | Hideo Yasunaga Hirotaka Chikuda Kiyohide Fushimi Hiromasa Horiguchi Toru Akiyama Kazuo Saita |
| author_sort | Hideo Yasunaga |
| collection | DOAJ |
| description | Objective To examine the incidence of vertebral osteomyelitis (VO) and the clinical features of VO focusing on risk factors for death using a Japanese nationwide administrative database.Design Retrospective observational study.Setting Hospitals adopting the Diagnosis Procedure Combination system during 2007–2010.Participants We identified 7118 patients who were diagnosed with VO (International Classification of Diseases, 10th Revision codes: A18.0, M46.4, M46.5, M46.8, M46.9, M48.9 and M49.3, checked with the detailed diagnoses in each case and all other codes indicating the presence of a specific infection) and hospitalised between July and December, 2007–2010, using the Japanese Diagnosis Procedure Combination database.Main outcome measures The annual incidence of VO was estimated. Logistic regression analysis was performed to analyse factors affecting in-hospital mortality in the VO patients. Dependent variables included patient characteristics (age, sex and comorbidities), procedures (haemodialysis and surgery) and hospital factors (type of hospital and hospital volume).Results Overall, 58.9% of eligible patients were men and the average age was 69.2 years. The estimated incidence of VO increased from 5.3/100 000 population per year in 2007 to 7.4/100 000 population per year in 2010. In-hospital mortality was 6%. There was a linear trend between higher rates of in-hospital mortality and greater age. A higher rate of in-hospital mortality was significantly associated with haemodialysis use (ORs, 10.56 (95% CI 8.12 to 13.74)), diabetes (2.37 (1.89 to 2.98)), liver cirrhosis (2.63 (1.49 to 4.63)), malignancy (2.68, (2.10 to 3.42)) and infective endocarditis (3.19 (1.80 to 5.65)).Conclusions Our study demonstrates an increasing incidence of VO, and defines risk factors for death with a nationwide database. Several comorbidities were significantly associated with higher rates of in-hospital death in VO patients. |
| format | Article |
| id | doaj-art-e7ebc85f48b64988bcb57b829dd1f47b |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2013-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-e7ebc85f48b64988bcb57b829dd1f47b2025-02-10T14:55:09ZengBMJ Publishing GroupBMJ Open2044-60552013-03-013310.1136/bmjopen-2012-002412Incidence and risk factors for mortality of vertebral osteomyelitis: a retrospective analysis using the Japanese diagnosis procedure combination databaseHideo Yasunaga0Hirotaka Chikuda1Kiyohide Fushimi2Hiromasa Horiguchi3Toru Akiyama4Kazuo Saita55 Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Bunkyo-ku, Tokyo, Japan1 Orthopaedic Surgery, Gunma University Graduate School of Medicine School of Medicine Faculty of Medicine, Gunma, JapanCenter for Well-being Research Advancement, Insitute of Science Tokyo, Tokyo, JapanDepartment of Health Management and Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University, Saitama, JapanDepartment of Orthopaedic Surgery, Saitama Medical Center, Jichi Medical University, Saitama, JapanObjective To examine the incidence of vertebral osteomyelitis (VO) and the clinical features of VO focusing on risk factors for death using a Japanese nationwide administrative database.Design Retrospective observational study.Setting Hospitals adopting the Diagnosis Procedure Combination system during 2007–2010.Participants We identified 7118 patients who were diagnosed with VO (International Classification of Diseases, 10th Revision codes: A18.0, M46.4, M46.5, M46.8, M46.9, M48.9 and M49.3, checked with the detailed diagnoses in each case and all other codes indicating the presence of a specific infection) and hospitalised between July and December, 2007–2010, using the Japanese Diagnosis Procedure Combination database.Main outcome measures The annual incidence of VO was estimated. Logistic regression analysis was performed to analyse factors affecting in-hospital mortality in the VO patients. Dependent variables included patient characteristics (age, sex and comorbidities), procedures (haemodialysis and surgery) and hospital factors (type of hospital and hospital volume).Results Overall, 58.9% of eligible patients were men and the average age was 69.2 years. The estimated incidence of VO increased from 5.3/100 000 population per year in 2007 to 7.4/100 000 population per year in 2010. In-hospital mortality was 6%. There was a linear trend between higher rates of in-hospital mortality and greater age. A higher rate of in-hospital mortality was significantly associated with haemodialysis use (ORs, 10.56 (95% CI 8.12 to 13.74)), diabetes (2.37 (1.89 to 2.98)), liver cirrhosis (2.63 (1.49 to 4.63)), malignancy (2.68, (2.10 to 3.42)) and infective endocarditis (3.19 (1.80 to 5.65)).Conclusions Our study demonstrates an increasing incidence of VO, and defines risk factors for death with a nationwide database. Several comorbidities were significantly associated with higher rates of in-hospital death in VO patients.https://bmjopen.bmj.com/content/3/3/e002412.full |
| spellingShingle | Hideo Yasunaga Hirotaka Chikuda Kiyohide Fushimi Hiromasa Horiguchi Toru Akiyama Kazuo Saita Incidence and risk factors for mortality of vertebral osteomyelitis: a retrospective analysis using the Japanese diagnosis procedure combination database BMJ Open |
| title | Incidence and risk factors for mortality of vertebral osteomyelitis: a retrospective analysis using the Japanese diagnosis procedure combination database |
| title_full | Incidence and risk factors for mortality of vertebral osteomyelitis: a retrospective analysis using the Japanese diagnosis procedure combination database |
| title_fullStr | Incidence and risk factors for mortality of vertebral osteomyelitis: a retrospective analysis using the Japanese diagnosis procedure combination database |
| title_full_unstemmed | Incidence and risk factors for mortality of vertebral osteomyelitis: a retrospective analysis using the Japanese diagnosis procedure combination database |
| title_short | Incidence and risk factors for mortality of vertebral osteomyelitis: a retrospective analysis using the Japanese diagnosis procedure combination database |
| title_sort | incidence and risk factors for mortality of vertebral osteomyelitis a retrospective analysis using the japanese diagnosis procedure combination database |
| url | https://bmjopen.bmj.com/content/3/3/e002412.full |
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