أعرض في EDS

Characteristics and predictors of outcome of spontaneous spinal epidural abscesses treated conservatively: A retrospective cohort study in a referral center

التفاصيل البيبلوغرافية
العنوان: Characteristics and predictors of outcome of spontaneous spinal epidural abscesses treated conservatively: A retrospective cohort study in a referral center
المؤلفون: Apostolos H. Karantanas, Achilleas Gikas, Nikolaos Spernovasilis, Stelios Demetriou, Georgios Hamilos, Maria Bachlitzanaki, Ioannis Gialamas, Kalliopi Alpantaki
المصدر: Clinical neurology and neurosurgery. 156
سنة النشر: 2016
مصطلحات موضوعية: Adult, Male, Methicillin-Resistant Staphylococcus aureus, medicine.medical_specialty, Weakness, Cord, medicine.drug_class, Antibiotics, Conservative Treatment, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Recurrence, medicine, Humans, 030212 general & internal medicine, Treatment Failure, Abscess, Spinal Cord Injuries, Aged, Retrospective Studies, Aged, 80 and over, Muscle Weakness, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, Retrospective cohort study, General Medicine, Middle Aged, Staphylococcal Infections, medicine.disease, Prognosis, Surgery, Anti-Bacterial Agents, Treatment Outcome, Epidural Abscess, Radiological weapon, Sensation Disorders, Referral center, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery
الوصف: Objective Recent studies have shown that in carefully selected patients, conservative treatment alone can be an option in the management of spinal epidural abscess (SEA). The aim of this study was to identify prognostic factors of outcome in patients with spontaneous SEA treated conservatively. Patients and methods A retrospective cohort study of all patients with spontaneous SEA treated with antibiotics alone from January 2012 to December 2015 was conducted in a 1200-bed tertiary referral center. Demographic, clinical, microbiological, and radiological characteristics were analyzed. Failure of medical treatment was defined as the need for delayed surgical intervention, no neurological improvement or deterioration, death due to the infection, or relapse after hospital discharge. Results We identified 21 patients diagnosed with spontaneous SEA treated conservatively. Median age was 72 years and 10 patients were male. Eleven patients presented with radicular weakness and/or radicular sensory deficit, or incomplete cord injury. Inflammatory markers were markedly elevated in all patients. Thirteen patients were successfully treated with conservative treatment, while among 8 patients with treatment failure, 1 died due to the infection. Presence of serious neurological deficits and infection due to methicillin-resistant S. aureus (MRSA) were associated with failure of conservative treatment. Notably, neither the extension nor the location of the abscess on magnetic resonance imaging (MRI) was associated with failed medical management. Conclusions A significant proportion of patients with spontaneous SEA can respond to antibiotic treatment alone. However, in patients with infection due to MRSA or with severe neurological impairment, conservative management has an increased risk of failure.
تدمد: 1872-6968
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1797ade076ae8f6ece3f1afeb606633e
https://pubmed.ncbi.nlm.nih.gov/28284111
حقوق: CLOSED
رقم الأكسشن: edsair.doi.dedup.....1797ade076ae8f6ece3f1afeb606633e
قاعدة البيانات: OpenAIRE
الوصف
تدمد:18726968