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

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.