Analysis of risk factors for prolonged postoperative hospitalization in patients with brucellosis spondylitis
10.3760/cma.j.cn121113-20230725-00041
- VernacularTitle:布鲁杆菌脊椎炎术后住院时间延长的危险因素分析
- Author:
Yasin PARHAT
1
;
Mardan MURADIL
;
Weibin SHENG
;
Mamat MARDAN
Author Information
1. 新疆医科大学第一附属医院脊柱外科，乌鲁木齐 830054
- Keywords:
Brucellosis;
Spondylitis;
Length of stay;
Risk factors
- From:
Chinese Journal of Orthopaedics
2023;43(21):1433-1440
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze risk factors for prolonged postoperative hospitalization in patients with Brucella spondylitis (BS).Methods:A total of 130 patients with BS who underwent surgical treatment in the Department of Spine Surgery, the First Affiliated Hospital of Xinjiang Medical University from June 2011 to December 2021 were retrospectively analyzed. There were 95 males and 35 females, aged 51.53±12.26 years (range, 20-76 years). The 75th percentile of patients' hospitalization time was used as the critical value, and hospitalization time≥75% quartile was defined as prolonged hospitalization time. Baseline data, clinical outcomes, laboratory test indices, and imaging findings were compared between patients with prolonged and normal length of stay. Indicators with statistically significant differences between the two groups were included in a binary logistic regression analysis to determine independent risk factors for prolonged postoperative hospitalization for BS. The receiver operating characteristic (ROC) curve was plotted for subjects with prolonged postoperative hospitalization, and the area under the curve (AUC) for each independent risk factor was calculated. Additionally, 95% confidence intervals (CI), sensitivity, and specificity were determined.Results:All patients were operated successfully. The length of hospitalization was 6.98±2.73 days (range, 6-20 days). The 75% quartile of the length of hospitalization was 9 days, so hospitalization time≤9 days was considered as normal length of hospitalization (normal group) and more than 9 days was considered as prolonged hospitalization (prolonged group), of which there were 99 cases in the normal group and 31 cases in the prolonged group. All patients were followed up for 12.3±3.2 months (range, 7-31 months). The results of univariate analysis showed elevated body mass index ( Z=901.00, P<0.001), recent wasting (χ 2=15.84, P<0.001), elevated erythrocyte sedimentation rate ( t=-4.82, P<0.001), elevated C-reactive protein ( Z=895.50, P<0.001), decreased albumin ( Z=2199.50, P<0.001), presence of epidural abscess on MRI (χ 2=10.45, P=0.001), and increased intraoperative blood loss (χ 2=8.81, P=0.003) may be risk factors for prolonged hospitalization after BS. Binary logistic regression analysis showed that increased body mass index ( OR=1.25, P=0.033), recent wasting ( OR=0.04, P=3.395), increased erythrocyte sedimentation rate ( OR=7.50, P<0.001), elevated C-reactive protein ( OR=4.71, P=0.008), and epidural abscess on MRI ( OR=3.69, P=0.033) were independent risk factors for prolonged postoperative hospital stay of BS, and the AUC of ROC was 0.70, 0.71, 0.71, 0.75, 0.66, respectively. The AUC of the combined prediction model was 0.89, and the prediction value was good. Conclusion:Elevated body mass index, recent wasting, elevated C-reactive protein, elevated erythrocyte sedimentation rate, and the presence of an epidural abscess on MRI are independent risk factors for prolonged postoperative hospitalization in patients with BS, and the combined prediction model has better predictive efficacy.
