External Review and Validation of a Spinal Epidural Abscess Predictive Score for Clinical Failure

Page, Paul S.; Gui, Michael; Steiner, Quinn; Ammanuel, Simon; Greeneway, Garret P.; Brooks, Nathaniel P.

doi:10.1016/j.wneu.2022.04.068

Cited by 3 publications

(1 citation statement)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most often, follow-up was reported as a mean and a range, with further details omitted. It was also typically not clearly reported how many patients may have been excluded from the study due to inadequate follow-up [2,4,5,[9][10][11][12][13][14][15][16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Patients Follow-up for Spinal Epidural Abscess as a Critical Treatment Plan Consideration

MacNeille¹,

Lay²,

Razzouk³

et al. 2023

Cureus

View full text Add to dashboard Cite

Introduction: Spinal epidural abscess (SEA) is a rare process with significant risk for morbidity and mortality. Treatment includes an extended course of antibiotics with or without surgery depending on the clinical presentation. Both non-operative and surgically treated patients require close follow-up to ensure the resolution of the infection without recurrence and/or progression of neurologic deficits. No previous study has looked specifically at follow-up in the SEA population, but the review of the literature does show evidence of varying degrees of difficulty with follow-up for this patient population.Methods: This retrospective review looked at follow-up for 147 patients with SEA at a single institution from 2012 to 2021. Statistical analyses were performed to assess differences between groups of surgical versus non-surgical patients and those with adequate versus inadequate follow-up.Results: Sixty-two of 147 (42.2%) patients had inadequate follow-up (less than 90 days) with their surgical team, and 112 of 147 (76.2%) patients had inadequate follow-up (less than 90 days) with infectious disease (ID). The primary statistically significant difference between patients with adequate versus inadequate follow-up was found to be surgical status with those treated surgically more likely to have adequate followup than those treated non-operatively.Conclusion: Improved follow-up in surgical patients should be considered as a factor when deciding on surgical versus non-operative treatment in the SEA patient population. Extra efforts coordinating follow-up care should be made for SEA patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Patients Follow-up for Spinal Epidural Abscess as a Critical Treatment Plan Consideration

MacNeille¹,

Lay²,

Razzouk³

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

External Validation of Predictive Models for Failed Medical Management of Spinal Epidural Abscess

Azad,

Kalluri,

Jiang

et al. 2024

World Neurosurgery

View full text Add to dashboard Cite

Keeping It Simple: Developing a Prognostic Tool for Spinal Epidural Abscess

Boukebous,

Petrie,

Baker

2023

Global Spine Journal

View full text Add to dashboard Cite

Study Design A retrospective study. Objective To develop a prognostic score for mortality and treatment failure in Spinal epidural abscess (SEA), based on simplicity and multidimensional assessment principles. Methods One-hundred-fifty patients were reviewed. Variables assessed included comorbidities, functional status, clinical presentation, Frankel classification, and biochemical and radiological parameters. The main outcomes were the 90-day mortality and treatment failure, corresponding to any intensification of the initial treatment plan. Variables were sorted out with a factorial analysis. Logistic regressions were performed, and the new score was derived from the coefficients. ROC curves with Area Under Curve, calibration plots, and cross-validation were performed. Results Forty-three patients (29%) had treatment failure, and 15 died (10%) by 90 days. Factorization created 3 groups: C omorbidities (C), S everity (S), and F unction (F). For 90-day mortality, Odds ratios were 1.20 ( P = .0002), 1.15, ( P = .03), 1.36, ( P < 10−4) for C, S, F, respectively. The new score ‘ CSF’ had 1 point per item, ranging from zero to 3. OR increased by 1.2/point for 90-day mortality ( P < 10−4), AUC was .86. For failures OR increased by 1.15/point ( P = .014), AUC was .58, and increased to .64 for patients who survived after 90 days, probably due to competing risks. Conclusions Comorbidities, Severity, and Function is a new simplistic tool, easy to use in daily practice; its performances were excellent for 90-day mortality, and acceptable for failures. Simple tools are more likely to be adopted into practice. External validation of this technique is desirable.

show abstract

External Review and Validation of a Spinal Epidural Abscess Predictive Score for Clinical Failure

Cited by 3 publications

References 12 publications

Patients Follow-up for Spinal Epidural Abscess as a Critical Treatment Plan Consideration

Patients Follow-up for Spinal Epidural Abscess as a Critical Treatment Plan Consideration

External Validation of Predictive Models for Failed Medical Management of Spinal Epidural Abscess

Keeping It Simple: Developing a Prognostic Tool for Spinal Epidural Abscess

Contact Info

Product

Resources

About