Factors associated with the time required for CRP normalization in pyogenic spondylitis: A retrospective observational study

Takuya Takahashi, MD; Hiroyuki Inose, MD, PhD; Takashi Hirai, MD, PhD; Yu Matsukura, MD, PhD; Shingo Morishita, MD, PhD; Satoru Egawa, MD, PhD; Jun Hashimoto, MD, PhD; Kunihiko Takahashi, PhD; Toshitaka Yoshii, MD, PhD

North American Spine Society Journal (Mar 2024)

Factors associated with the time required for CRP normalization in pyogenic spondylitis: A retrospective observational study

Takuya Takahashi, MD,
Hiroyuki Inose, MD, PhD,
Takashi Hirai, MD, PhD,
Yu Matsukura, MD, PhD,
Shingo Morishita, MD, PhD,
Satoru Egawa, MD, PhD,
Jun Hashimoto, MD, PhD,
Kunihiko Takahashi, PhD,
Toshitaka Yoshii, MD, PhD

Affiliations

Takuya Takahashi, MD: Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
Hiroyuki Inose, MD, PhD: Department of Orthopedic and Trauma Research, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya-shi, Saitama 343-8555, Japan; Corresponding author. Department of Orthopedic and Trauma Research, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Tel: (+81) 35-8035279
Takashi Hirai, MD, PhD: Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
Yu Matsukura, MD, PhD: Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
Shingo Morishita, MD, PhD: Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
Satoru Egawa, MD, PhD: Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
Jun Hashimoto, MD, PhD: Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
Kunihiko Takahashi, PhD: Department of Biostatistics, M&D Data Science Center, Tokyo Medical and Dental University, 2-3-10 Kanda Surugadai, Chiyoda-ku, Tokyo 101‑0062, Japan
Toshitaka Yoshii, MD, PhD: Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan

Journal volume & issue: Vol. 17
p. 100301

Abstract

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ABSTRACT: Background: Treatment for pyogenic spondylitis tends to be prolonged; however, few studies have examined the factors associated with the time required for infection control. Therefore, we analyzed a consecutive cohort of patients to identify factors associated with the time required to control infection in pyogenic spondylitis. This study aimed to clarify the factors linked to the duration necessary for achieving infection control in cases of pyogenic spondylitis, using C-reactive protein (CRP) normalization as an indicator. Methods: In this retrospective observational study, we investigated 108 patients diagnosed with pyogenic spondylitis. We evaluated the number of days from the first visit to CRP normalization; for cases wherein CRP did not normalize, the number of days to the date of final blood sampling was evaluated. In the present study, infection control in pyogenic spondylitis was defined as a CRP falling within the normal range (≤0.14 mg/dL). We performed univariate and multivariate Cox regression analyses to identify various factors associated with the time required for CRP normalization in pyogenic spondylitis. Results: The mean time required for CRP normalization was 148 days. Univariate Cox regression analysis showed that the serum creatinine level, estimated glomerular filtration rate (eGFR), lymphocyte percentage, neutrophil percentage, CRP level, CRP-albumin ratio, and neutrophil-to-lymphocyte ratio were significantly associated with the time required to control infection. Multivariate Cox regression analysis showed that a higher neutrophil percentage, diabetes mellitus, and a lower eGFR were the independent factors associated with a longer infection control time. Conclusions: We found that a higher neutrophil percentage, diabetes mellitus, and a lower eGFR were significantly associated with a longer time for CRP normalization in pyogenic spondylitis. These findings may help identify patients with pyogenic spondylitis who are at a high risk for an extended infection control period.

Published in North American Spine Society Journal

ISSN: 2666-5484 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery; Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system
Website: https://www.journals.elsevier.com/north-american-spine-society-journal-nassj/

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