DOS 2018

252 · DOS Abstracts Vertebral osteomyelitis: a mortality analysis comparing surgical and conservative management Spogmai Zadran , Andreas Kiesbye Øvlisen, Peter Heide Pedersen, Torben Tvedebrink, Søren Peter Eiskjær Orthopedic department, Aalborg University Hospital; statistisk ved Matematisk Institut, Aalborg University Background: Vertebral osteomyelitis (VO) is a disease targeting the frail. Surgical treatment of VO is major surgery. The question is if major surgery in this population is justifiable. Purpose / Aim of Study: First, to evaluate the mortality outcome of surgical treatment of VO at our institution compared with patients treated conserva- tively. Second, to evaluate factors influencing the mortality after VO. Materials and Methods: Inclusion criteria: all patients diagnosed with VO in the North Denmark Region in the years 2004-2013, identified by searching the Danish National Registry of Patients. All patients were treated at a single institu- tion. Exclusion criteria: treatment not following standardized guidelines, patients younger than 18 years, or previous treatment for VO. Kaplan-Meier analysis was used to evaluate mortality differences between the two treatment modali- ties. Penalized Cox proportional hazard was used for the predictive modeling of factors influencing mortality Findings / Results: 125 patients, 89 males and 36 females, were included in the study. Mean age was 67(38-92) years. 75 of which received surgical treat- ment and 50 conservative treatment. No significant difference in mortality was found after one, two and five years, comparing surgical and conservative man- agement. Significant factors included in the predictive model were the presence of cardiovascular disease, Charlson Comorbidity Index (CCI), infection of the thoracic spine, Karnofsky score and delayed treatment with antibiotics Conclusions: Patients undergoing surgical management according to standard- ized guidelines showed no higher mortality than those allocated to conservative treatment. The treatment modality was without importance, but cardiovascular disease, CCI, thoracic infection, Karnofsky score and delayed antibiotic treat- ment were associated with an increased mortality 193.