RESUMO
Fundamento y objetivos: Conocer la incidencia y mortalidad de pacientes hospitalizados por osteomielitis en España. Material y método: Se realizó un estudio observacional de población ingresada con diagnóstico principal de osteomielitis en hospitales españoles según el conjunto mínimo de datos al alta hospitalaria, entre 1997-2014 (29.290 casos). Resultados: La incidencia de ingresos por osteomielitis fue de 3,85 (IC 99%: 3,79-3,91) casos/100.000 habitantes y año. El riesgo relativo de los hombres fue de 2,02. La mortalidad intrahospitalaria fue del 1,72% (IC 99%: 1,4 -1,93). La mortalidad de la osteomielitis asociada a septicemia alcanzó el 27,12% (IC 99%: 20,5-35), la de la infección por Staphylococcus aureus resistente a meticilina (MRSA) el 5,5% (IC 99%: 2,18-13,2) y la de mayores de 64 años el 4,65% (IC 99%: 3,89-5,0). En el análisis multivariante la mortalidad se asoció de forma independiente a los diagnósticos de septicemia, osteomielitis aguda, ingresos urgentes, infección por MRSA, mayores de 64 años, comorbilidad y mujeres (p<0,001). Conclusiones: La incidencia de hospitalizaciones por osteomielitis en España es sustancial. La sepsis, la edad superior a los 64 años e infección por MRSA son factores importantes de riesgo de muerte
Background and objectives: To understand the incidence and mortality of patients hospitalised for osteomyelitis in Spain. Material and method: An observational study of the population admitted to Spanish hospitals with a primary diagnosis of osteomyelitis, according to the minimum basic data set for hospital discharge (MBDS), between 1997 - 2014 (29 290 cases) was carried out. Results: The incidence was 3.85 cases/100,000 inhabitants per year. Relative risk for males was 2.02. In-hospital mortality was 1.72% (99% CI: 1.4-1.93). The mortality of osteomyelitis associated to septicemia reached 27.12% (99%CI: 20.5-35), that of infection by methicillin-resistant Staphylococcus aureus (MRSA) was 5.5% (99% CI: 2.18-13.2), and that of those aged over 64 was 4.65% (99% CI: 3.89-5.0). In a multivariate analysis, mortality was associated independently with a diagnosis of septicemia, acute osteomyelitis, urgent admissions, infection with MRSA, being over 64 and female. Conclusions: The incidence of hospitalisations for osteomyelitis in Spain is substantial. Sepsis, being over 64 and MRSA infection are important risk factors for death
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Osteomielite/epidemiologia , Osteomielite/mortalidade , Espanha/epidemiologia , Mortalidade Hospitalar , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Análise Multivariada , Fatores de RiscoRESUMO
BACKGROUND AND OBJECTIVES: To understand the incidence and mortality of patients hospitalised for osteomyelitis in Spain. MATERIAL AND METHOD: An observational study of the population admitted to Spanish hospitals with a primary diagnosis of osteomyelitis, according to the minimum basic data set for hospital discharge (MBDS), between 1997 - 2014 (29 290 cases) was carried out. RESULTS: The incidence was 3.85 cases/100,000 inhabitants per year. Relative risk for males was 2.02. In-hospital mortality was 1.72% (99% CI: 1.4-1.93). The mortality of osteomyelitis associated to septicemia reached 27.12% (99%CI: 20.5-35), that of infection by methicillin-resistant Staphylococcus aureus (MRSA) was 5.5% (99% CI: 2.18-13.2), and that of those aged over 64 was 4.65% (99% CI: 3.89-5.0). In a multivariate analysis, mortality was associated independently with a diagnosis of septicemia, acute osteomyelitis, urgent admissions, infection with MRSA, being over 64 and female. CONCLUSIONS: The incidence of hospitalisations for osteomyelitis in Spain is substantial. Sepsis, being over 64 and MRSA infection are important risk factors for death.
