A scoring system for the preoperative evaluation of prognosis in spinal infection: the MSI-20 score

Lener, Sara; Wipplinger, Christoph; Lang, Anna; Hartmann, Sébastian; Abramović, Anto; Thomé, Claudius

doi:10.1016/j.spinee.2021.12.015

Cited by 9 publications

(8 citation statements)

References 35 publications

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“…Notably, Australia does not include measurement of AA in nutritional surveys, such that the prevalence in the community is unknown. 2 A few recent Australian studies have examined the prevalence of AA deficiency in general surgery, vascular surgery, and acute medicine patients with ranges of 50%-70%. [6][7][8] Our results are in keeping with these studies, suggesting scurvy is not as rare as once assumed.…”

Section: Discussionmentioning

confidence: 99%

“…More than three‐quarters of patients had depletion and 46% of patients had deficiency. Notably, Australia does not include measurement of AA in nutritional surveys, such that the prevalence in the community is unknown 2 . A few recent Australian studies have examined the prevalence of AA deficiency in general surgery, vascular surgery, and acute medicine patients with ranges of 50%–70% 6–8 .…”

Section: Discussionmentioning

confidence: 99%

“…Even after successful initial treatment, patients may develop chronic infections or painful deformity requiring complex reconstructive spine surgery which carries significant morbidity. 1,2 Vitamin C or AA is a water-soluble vitamin, essential for its antioxidant properties and role in enzyme synthesis. It is crucial in neutrophil function and collagen formation, which are necessary processes in the response to infections and surgery.…”

Section: Introductionmentioning

confidence: 99%

“…The mainstay of treatment is a prolonged course of antibiotics, with surgery indicated in select patients. Even after successful initial treatment, patients may develop chronic infections or painful deformity requiring complex reconstructive spine surgery which carries significant morbidity 1,2 …”

Section: Introductionmentioning

confidence: 99%

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Ascorbic acid deficiency amongst spondylodiscitis patients

Solis,

Taylor,

Brooks

et al. 2024

ANZ Journal of Surgery

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BackgroundSpondylodiscitis can be a disabling and life‐threatening infection. Ascorbic Acid is crucial for neutrophil function and collagen formation. Its association and clinical relevance in spondylodiscitis has not been previously examined.AimsTo determine the prevalence, characteristics, and clinical outcomes of spondylodiscitis patients with Ascorbic Acid deficiency.MethodsSixty‐eight consecutive patients admitted with spondylodiscitis, between December 2021 and August 2023 were included. Clinical characteristics, Ascorbic Acid levels and clinical outcomes were evaluated.ResultsThirty‐seven patients had Ascorbic Acid levels taken during admission. The median initial Ascorbic Acid level was 15 μmol/L with an IQR 6.5–27 μmol/L. Depletion defined as <28 μmol/L was present in 78% of patients. Deficiency defined as ≤11 μmol/L was present in and 46% of patients. Patients with depletion were more likely to require Intensive Care Admission (absolute risk increase = 24.1%; 2.6%–45.7%). Fifteen patients had repeat serum levels taken during admission with median increase of 17 μmol/L and an IQR 0–26 μmol/L. Patients that received supplementation had a significantly greater increase in Ascorbic Acid levels compared with those that did not receive supplementation (P = 0.002).ConclusionAscorbic acid deficiency is highly prevalent amongst spondylodiscitis patients. Depletion was associated with worse outcomes. Replacement significantly increased serum levels in comparison to standard hospital diet. The clinical significance of replacement remains to be evaluated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ascorbic acid deficiency amongst spondylodiscitis patients

Solis,

Taylor,

Brooks

et al. 2024

ANZ Journal of Surgery

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“…Spinal infections (SI) are feared and potentially life-threatening conditions, and their incidence has been increasing in recent years [ 1 ]. SI can arise primarily through hematogenous spread, or secondarily following spine surgery or spinal interventions leading to surgical site infections (SSI).…”

Section: Introductionmentioning

confidence: 99%

Utility of the LACE index to assess risk of mortality and readmission in patients with spinal infections

Schär,

Branca,

Raabe

et al. 2024

Neurosurg Rev

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Retrospective cohort study. To assess the utility of the LACE index for predicting death and readmission in patients with spinal infections (SI). SIs are severe conditions, and their incidence has increased in recent years. The LACE (Length of stay, Acuity of admission, Comorbidities, Emergency department visits) index quantifies the risk of mortality or unplanned readmission. It has not yet been validated for SIs. LACE indices were calculated for all adult patients who underwent surgery for spinal infection between 2012 and 2021. Data were collected from a single academic teaching hospital. Outcome measures included the LACE index, mortality, and readmission rate within 30 and 90 days. In total, 164 patients were analyzed. Mean age was 64.6 (± 15.1) years, 73 (45%) were female. Ten (6.1%) patients died within 30 days and 16 (9.8%) died within 90 days after discharge. Mean LACE indices were 13.4 (± 3.6) and 13.8 (± 3.0) for the deceased patients, compared to 11.0 (± 2.8) and 10.8 (± 2.8) for surviving patients (p = 0.01, p < 0.001), respectively. Thirty-seven (22.6%) patients were readmitted ≤ 30 days and 48 (29.3%) were readmitted ≤ 90 days. Readmitted patients had a significantly higher mean LACE index compared to non-readmitted patients (12.9 ± 2.1 vs. 10.6 ± 2.9, < 0.001 and 12.8 ± 2.3 vs. 10.4 ± 2.8, p < 0.001, respectively). ROC analysis for either death or readmission within 30 days estimated a cut-off LACE index of 12.0 points (area under the curve [AUC] 95% CI, 0.757 [0.681–0.833]) with a sensitivity of 70% and specificity of 69%. Patients with SI had high LACE indices that were associated with high mortality and readmission rates. The LACE index can be applied to this patient population to predict the risk of early death or unplanned readmission.

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