Clinical Study
Impact of Anti-Inflammatory Drugs on Pyogenic Vertebral Osteomyelitis: A Prospective Cohort Study
Table 1
Characteristics of patients presenting pyogenic vertebral osteomyelitis receiving nonsteroidal anti-inflammatory drugs (NSAIDs) versus patients receiving no NSAID.
| Characteristics | Total () | No anti-inflammatory drugs intake () | Any anti-inflammatory drugs intake () | value | With NSAIDs intake () | value | With corticosteroids intake () | value |
| Age, years (median [IQR]) | 69 [53–78] | 70 [53–77] | 66 [52–78] | 0.72 | 62 [50–75] | 0.31 | 75 [53–78] | 0.38 | Gender, male, n (%) | 55 (71) | 34 (76) | 21 (64) | 0.25 | 17 (68) | 0.50 | 8 (57) | 0.18 | Antecedent, n (%) | | | | | | | | | Chronical back pain | 22 (28) | 13 (29) | 9 (27) | 0.81 | 7 (27) | 0.86 | 4 (29) | 1.00 | Inflammatory rheumatism | 4 (5) | 1 (2) | 5 (15) | 0.72 | 2 (8) | 0.55 | 2 (14) | 0.14 | Neoplasia | 16 (20) | 10 (22) | 3 (9) | 0.31 | 5 (19) | 0.77 | 2 (14) | 0.71 | Diabetes mellitus | 13 (17) | 13 (29) | 6 (18) | 0.62 | 0 | | 0 | | Neuropathy | 5 (6) | 3 (7) | 0 | | 0 | | 2 (14) | 0.58 | Drugs abusers | 4 (5) | 2 (4) | 2 (6) | 1.00 | 2 (8) | 0.62 | 0 | | Mild neurocognitive impairment | 2 (3) | 0 | 2 (6) | 1.00 | 2 (8) | | 0 | | Diagnosis delay, days (median [IQR]) | 30 [9–60] | 27 [9–56] | 32 [14–67] | 0.28 | 40 [17–75] | 0.10 | 26 [10–63] | 0.79 | Initial presentation, n (%) | | | | | | | | | Initial pain | 67 (87) | 34 (79) | 33 (97) | 0.04 | 25 (96) | 0.08 | 14 (100) | | Initial temperature >38°C | 43 (57) | 30 (70) | 13 (39) | 0.01 | 8 (32) | 0.002 | 6 (43) | 0.07 | Topography | | | | | | | | | Plurifocal | 13 (17) | 8 (18) | 5 (15) | 0.72 | 3 (12) | 0.74 | 3 (21) | 0.71 | Epiduritis | 30 (41) | 17 (42) | 13 (39) | 0.86 | 11 (42) | 0.95 | 4 (31) | 0.54 | Cervical localization | 16 (20) | 10 (22) | 6 (18) | 0.62 | 5 (19) | 0.77 | 2 (14) | 0.52 | Thoracic localization | 19 (24) | 11 (24) | 8 (24) | 0.93 | 8 (31) | 0.56 | 2 (14) | 0.71 | Lumbar localization | 42 (53) | 22 (49) | 20 (59) | 0.38 | 12 (46) | 0.82 | 12 (86) | 0.03 | Sacral localization | 12 (15) | 7 (16) | 5 (15) | 0.92 | 5 (19) | 0.69 | 1 (7) | 0.67 | Microbiology | | | | | | | | | MSSA | 27 (34) | 16 (36) | 11 (32) | 0.77 | 8 (31) | 0.68 | 6 (43) | 0.62 | CoNS | 12 (15) | 8 (18) | 4 (12) | 0.54 | 4 (15) | 1.00 | 1 (7) | 0.67 | MRSA | 1 (1) | 1 (2) | 0 | | 0 | | 0 | | Streptococcus non-Enterococcus | 17 (22) | 8 (18) | 9 (27) | 0.35 | 6 (23) | 0.59 | 5 (36) | 0.16 | Enterococcus spp. | 3 (4) | 1 (2) | 2 (6) | 0.57 | 2 (8) | 0.55 | 0 | | Escherichia coli | 8 (10) | 4 (9) | 4 (12) | 0.72 | 3 (12) | 0.70 | 1 (7) | 1.00 | Klebsiella pneumoniae | 2 (3) | 1 (2) | 1 (3) | 1.00 | 0 | | 1 (7) | 0.42 | Others | 11 (14) | 7 (16) | 4 (12) | 0.75 | 3 (12) | 0.74 | 1 (7) | 0.67 | In-hospital presentation | | | | | | | | | Pain | 72 (91) | 39 (87) | 33 (97) | 0.23 | 25 (96) | 0.25 | 14 (100) | | Fever | 41 (53) | 26 (61) | 15 (44) | 0.15 | 11 (42) | 0.14 | 5 (36) | 0.11 | SIRS | 22 (28) | 16 (36) | 6 (18) | 0.08 | 3 (12) | 0.05 | 3 (21) | 0.51 | Motor weakness | 10 (13) | 6 (14) | 4 (12) | 1.00 | 2 (8) | 0.70 | 2 (15) | 1.00 | Biological | | | | | | | | | CRP, mean (mg/L) | 114 [62–229] | 108 [68–240] | 125 [53–190] | 0.42 | 80 [44–182] | 0.25 | 111 [62–207] | 0.59 | Positive blood culture (n, %) | 61 (78) | 32 (73) | 29 (85) | 0.18 | 21 (81) | 0.45 | 14 (100) | | Outcome | | | | | | | | | Cure rate at 1 year | 72 (72/79) | 41 (41/45) | 31 (31/34) | 1.00 | 24 (24/26) | 1.00 | 13 (13/14) | 1.00 |
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NSAIDs: nonsteroidal anti-inflammatory drugs; IQR: interquartile range; MSSA: methicillin-susceptible Staphylococcus aureus; CoNS: coagulase negative staphylococci; MRSA: methicillin-resistant Staphylococcus aureus; SIRS: systemic inflammatory response syndrome; CRP: C-reactive protein; : not applicable.
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