Introduction Spondylodiscitis is a rare infectious pathology with high morbidity and mortality that affects the intervertebral disc and adjacent vertebrae. It is most commonly found in the lumbar spine. It is mainly caused by haematogenous dissemination. It is a diagnostic challenge because its main manifestation, low back pain, is a prevalent symptom in the population. Methods A retrospective study of patients diagnosed with spondylodiscitis between 2010–2020 (n=60) was carried out. Exclusion criteria (n=14): follow-up less than one year, previous spinal surgery, first year mortality. Measurements made in plain radiology. Statistical analysis STATA 15.2. Statistical significance p<0,05. Results Average age: 68.17 years, 55% were males, 45% were females. Risk factors analyzed: 26.09% of the patients had diabetes, 8.70% kidney disease, 6.52% rheumatism, 6.52% were PVDA; about smoking 10.87% were smokers, 17.39% ex-smokers and the 71.74% were non-smokers; 8.70% had prescriptions of immunosuppressants and 19.57% had cancer before or during this episode. 50% had previous infection (n=23); 34.78% had urinary infection, 13.04% had knee prosthesis, 8.69% had respiratory infection, endocarditis the 30.43%, 17.36% had another sort of infection. The average delay to diagnosis was 40.36 days (SD 37.68). Total duration of antibiotic therapy, including days of hospital stay and those which were ambulatory: 134 days (SD 129.96); duration of hospitalization: 43 days. Surgical treatment was performed in 15.56% of the patients. a spacer was the technique used in the 14.29% of the patients; although the fixation was used in the 71.42% of the patients, the majority was a posterior fixation with the 57.14%, the anterior fixation was only used in the 14.29%. The acute complications found in this study were in this order, abscess with nearly half of the patients (n=22), phlegmon (n=3), vertebral destruction (n=2) and meningitis (n=1). No differences were obtained in the angle of kyphosis after pathology (p. 052), no increase in complications due to surgery (p=0.62), no difference in the cure of patients with targeted treatment (p=0.57), nor with surgical treatment (p=0.95), nor in the percentage of cure with diagnostic delay (p=0.76). Conclusions Spondylodiscitis is a pathology with non-specific symptoms, which leads to diagnostic delay. The cure rate with medical treatment is high, but it is essential to identify the causal germ in order to initiate targeted antibiotherapy and avoid the appearance of complications and long-term sequelae.
INTRODUCTION In Spain, the state of alarm, decreed by the COVID-19 pandemic, forced a home confinement that included the suspension of school activity. Our purpose is to examine how it affected the epidemiology of pediatric fractures in a tertiary hospital. MATERIAL AND METHODS Retrospective cohort study comparing the epidemiology and management of pediatric fractures in our centre during the COVID-19 pandemic in relation to the previous year. The "pandemic" cohort includes patients seen during this state of alarm (03/14/2020 to 06/21/20); and the "pre-pandemic" cohort the same period of 2019. RESULTS Between both periods, 233 pediatric patients were treated for 258 fractures. There were no significant changes in their age or sex. The incidence of fractures was decreased by 66%. Despite this decrease, the percentage of fractures that required surgical intervention doubled. The time until the evaluation in the emergency room was also modified, with a higher proportion of patients seen more than 24 hours after the trauma. Regarding the anatomical locations, a reduction in bicortical fractures stands out, in contrast to greenstick fractures and epiphysiolysis. CONCLUSIONS The COVID-19 pandemic has changed the epidemiology of pediatric fractures. There was a reduction in the incidence of fractures and a delay in hospital care, probably due to fear of going to the hospital due to the risk of contagion. Home confinement may justify the lower proportion of high-energy distal radius fractures, such as bicortical fractures.
INTRODUCTION The pandemic caused by the SARS-Cov-2 coronavirus has generated unprecedented pressure on healthcare systems. Higher mortality rates have been reported in elderly patients. Those with a hip fracture are especially vulnerable. MATERIAL AND METHODS Retrospective study in which we analyzed the management and associated perioperative complications rate in patients aged over 65 years who attended a tertiary hospital in Spain with hip fracture during the COVID-19 first alarm status decree . We compared the results with a cohort of similar patients treated during the same period in 2019. RESULTS A total of 102 hip fractures were recorded in 2019, with a mean age of 85 years. 87.5% were treated surgically in our hospital, with mean waiting time of 4.6 days and mean stay of 11.3 days. In 2020, 107 hip fractures were recorded, with a mean age of 86 years. A total of 74.6% underwent surgery in our center, with a mean waiting time of 2.8 days and a mean hospital stay of 10.9 days. The rate of major complications and exitus was 8.9% and 6.7% respectively in 2019, and 9.4% and 7.8% in 2020. CONCLUSIONS The number of hip fractures increased despite the declaration of the state of alarm in comparison with the decrease in the rest of the trauma emergencies. During this period the mean waiting time for surgery was shorter. There was no relevant variation in the demographic characteristics of the patients, nor in the rate of complications and reported exitus.
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