Yi-Ching Huang1, Chung-Han Ho2, Yeong-Jang Lin3, Hung-Jui Chen4, Su-Yen Liu5, Chia-Ling Wang6, Cheng-Heng Lin7, Jhi-Joung Wang2, Chih-Chiang Chien6. 1. Department of Internal Medicine, National Cheng Kung University Hospital. 2. Department of Medical Research, Chi-Mei Medical Center. 3. Department of Allergy, Immunology and Rheumatology, Chi-Mei Medical Center. 4. Department of Infectious Diseases, Chi-Mei Medical Center. 5. Nursing Department, Chi-Mei Medical Center. 6. Department of Nephrology, Chi-Mei Medical Center. 7. Department of Gastroenterology, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
Abstract
OBJECTIVE: This national cohort study investigated the incidence, site-specific mortality and prognostic factors of native septic arthritis (SA). METHODS: Tapping Taiwan's National Health Insurance Research Database, we identified inpatients with newly diagnosed SA between 1998 and 2012. They were categorized by site of infection and followed to calculate 30-day, 90-day and 1-year mortality. Predictors of mortality were calculated using Cox models. RESULTS: A total of 31 491 patients were identified as having SA, the most common site of infection being the knee (50.1%), followed by the hip (14.4%), other sites (26.8%), the shoulder (5.5%) and multiple sites (1.2%). Knee joint involvement was the most common site for all subgroups. Incidence increased from 9.8/105 in 1998 to 13.3/105 in 2012. The 30-day, 90-day and 1-year mortality rates were 4.3, 8.6 and 16.4% respectively. Predictors for mortality were hip infection, shoulder infection, multiple-site infection, being male, age ≥65 years old and comorbidities. We derived a mortality scoring model over age/SA site/comorbidity, and age ≥65 years old had the greatest risk contribution to mortality. No matter whether 1-month, 3-month or 1-year mortality was being considered, patients with the higher risk scores had the higher mortality rates (P < 0.0001). CONCLUSION: SA is an emerging infectious disease with a rising incidence, long duration of hospital stay and high mortality rate. The most common affected joint was knee for all subgroups. Patients aged ≥65 years old had a high SA incidence and the greatest risk contribution.
OBJECTIVE: This national cohort study investigated the incidence, site-specific mortality and prognostic factors of native septic arthritis (SA). METHODS: Tapping Taiwan's National Health Insurance Research Database, we identified inpatients with newly diagnosed SA between 1998 and 2012. They were categorized by site of infection and followed to calculate 30-day, 90-day and 1-year mortality. Predictors of mortality were calculated using Cox models. RESULTS: A total of 31 491 patients were identified as having SA, the most common site of infection being the knee (50.1%), followed by the hip (14.4%), other sites (26.8%), the shoulder (5.5%) and multiple sites (1.2%). Knee joint involvement was the most common site for all subgroups. Incidence increased from 9.8/105 in 1998 to 13.3/105 in 2012. The 30-day, 90-day and 1-year mortality rates were 4.3, 8.6 and 16.4% respectively. Predictors for mortality were hip infection, shoulder infection, multiple-site infection, being male, age ≥65 years old and comorbidities. We derived a mortality scoring model over age/SA site/comorbidity, and age ≥65 years old had the greatest risk contribution to mortality. No matter whether 1-month, 3-month or 1-year mortality was being considered, patients with the higher risk scores had the higher mortality rates (P < 0.0001). CONCLUSION: SA is an emerging infectious disease with a rising incidence, long duration of hospital stay and high mortality rate. The most common affected joint was knee for all subgroups. Patients aged ≥65 years old had a high SA incidence and the greatest risk contribution.