CO-MORBIDITY AND FORECASTING THE RISK OF POST-OPERATIVE INFECTIOUS COMPLICATIONS IN TUBERCULOUS SPONDYLITIS PATIENTS

Abstract

Goal of the study: to study co-morbidity and risk of post-operative infectious complications in tuberculous spondylitis patients with concurrent non-specific spinal osteomyelitis as per ASA, PITSS scales and Charlson score.Materials and methods. Surgical treatment of 41 patients with infectious spondylitis was retrospectively analyzed. Patients were divided into 2 groups. Tuberculous spondylitis patients were included into group 1 – 24 (58.5%), and those suffering from non-specific spinal osteomyelitis were included into group 2 (17.0-41.5%) More than half of tuberculous spondylitis patients were HIV positive (13/54.3%) and 16 out of 24 patients (66.7%) had generalized form of tuberculosis. The survival forecast for the patients after surgery was estimated by Charlson score, ASA score was used for evaluation of surgical and anesthetic risks, and risk of postoperative complications was assessed by PITSS (Postoperative infection treatment score for the spine) (2012).Results. Early and late infectious complications were detected in 4 (9.7%) of patients with ASA at 3-4 scores, Charlson score exceeding 5 and high risk as per PITSS (more than 21 scores). Tuberculous spondylitis patients had Charlson score exceeding 5 and high risk as per ASA (4 scores) more often compared to those suffering from non-specific spinal osteomyelitis. The majority of infectious spondylitis patients (28/57.5%) had medium and high risk of postoperative complications development as per PITSS. HIV positive tuberculous spondylitis patients had two fold risk of postoperative complications development compared to those HIV negative (χ2 = 4.53, OR = 2.76, p = 0.0012).

Keywords

• коморбидность
• туберкулез
• спондилит
• неспецифический остеомиелит позвоночника
• инфекционные осложнения операций