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Aggressive Surgical Intervention in End-Stage Renal Disease Patients with Spinal Epidural Abscess.
MedLine Citation:
PMID:  21631235     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Despite advances in imaging, as well as antibiotic and surgical treatment, spinal epidural abscess (SEA) remains a challenging problem in end-stage renal disease (ESRD) patients. This investigation assesses the influence of ESRD on clinical manifestations, complications, and outcomes in patients with SEA. Methods: This study retrospectively reviewed medical records of 41 patients with SEA treated during 2003-2006. The patients comprised two groups: group I (patients with ESRD) and group II (patients without ESRD). Patient characteristics, including age, gender, comorbidities, clinical presentations, laboratory data, locations of epidural abscess, and outcome, were recorded and compared. Results: The final sample comprised 41 patients. The mean age of the subjects was 62 + 12 years. The sample included 12 patients with ESRD and 29 without ESRD. The development of symptoms was similar for both groups. Group I patients displayed higher serum erythrocyte sedimentation rate (ESR) (108 + 26 vs. 81 + 31 mm/h, p = 0.014) and lower serum hematocrit (27.1 + 4.3 vs. 33.7 + 5.1%, p < 0.001) than group II patients. Overall survival at 3 months was 88.9% and 93.1% for patients in groups I and II, respectively (p = 0.876). Meanwhile, patients that underwent surgical decompression of epidural abscess received more surgeries than group I patients (1.08 vs. 0.55, p = 0.086), although the difference was not significant. Conclusions: ESRD is a risk factor for repeat surgery in patients with SEA. This investigation suggests that ESRD patients with SEA may require aggressive surgical intervention despite ESRD not affecting their long-term prognosis.
Authors:
Mei-Yi Wu; Tsai-Sheng Fu; Chih-Hsiang Chang; Hsiang-Hao Hsu; Ming-Yang Chang; Ya-Chung Tian; Cheng-Chieh Hung; Ji-Tseng Fang; Lih-Huei Chen; Yung-Chang Chen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-1
Journal Detail:
Title:  Renal failure     Volume:  -     ISSN:  1525-6049     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701128     Medline TA:  Ren Fail     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Nephrology, Taipei Medical University-Shuang Ho Hospital , Taipei , Taiwan.
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