Survival and Risk Factor Analysis in Patients with Septic Arthritis: A Retrospective Study of 192 Cases

Abstract

Background Septic arthritis (SA) poses a complex clinical puzzle and is associated with significant levels of morbidity and mortality. The objective of this study was (1) to explore overall mortality rates and (2) analyze and identify possible factors that might contribute to the risk of death in patients afflicted with SA. Methods This retrospective study focused on patients suffering from SA who received treatment at a German university hospital between January 01, 2011 to December, 31 2021. Identification of patients was carried out through International Classification of Diseases (ICD)-10 diagnosis codes specifically related to SA, denoted as "M00.-". The study analyzed the overall mortality rate as well as comorbidities, and pathogens as potential risk factors. Kaplan–Meier probability plots and odds ratios (OR) for mortality were calculated. Results In a cohort of 192 patients suffering from SA, 64 patients (33.3%) passed away during a mean follow-up time of 54.4 ± 42 months. The overall mortality was 17.5% at one year, 19.9% at two years and 28.3% at five years. Patients being 65 years or older (p < 0.001), arterial hypertension (p = 0.003), congestive heart failure (p = 0.001), chronic renal disease (p < 0.001), chronic liver disease (p = 0.013), peripheral vascular disease (p = 0.026), malignancy (p < 0.001), steroid use (p < 0.001), immunosuppression (p = 0.003) and intraabdominal infection (p = 0.049) demonstrated a significant higher rate of mortality. Comorbidities were found to be associated with mortality. Chronic renal disease (OR = 2.80; p = 0.000), malignancy (OR = 3.40; p = 0.006) and chronic heart failure (OR = 2.62; p = 0.039). Conclusion The vulnerable patient group demonstrated a notably elevated mortality rate. Understanding the intricate interplay of factors contributing to mortality is paramount. Prompt evaluation and addressing of individualized risk factors in the early stages could offer significant advantages in effectively managing and treating SA, thereby lowering the chances of mortality. These results underscore the critical need for vigilant monitoring of SA patients who have pre-existing chronic organ conditions, timely recognition, and prompt intervention for sepsis.