Aggressive Surgical Intervention in End-Stage Renal Disease Patients with Spinal Epidural Abscess

作者：Wu Mei Yi; Fu Tsai Sheng; Chang Chih Hsiang; Hsu Hsiang Hao; Chang Ming Yang; Tian Ya Chung; Hung Cheng Chieh; Fang Ji Tseng^*; Chen Lih Huei; Chen Yung Chang

来源：Renal Failure, 2011, 33(6): 582-586.

DOI：10.3109/0886022X.2011.585415

• Spinal epidural abscess
• end-stage renal disease
• surgical decompression
• back pain
• Staphylococcus aureus

Background: Despite advances in imaging, as well as antibiotic and surgical treatment, spinal epidural abscess (SEA) remains a challenging problem in end-stage renal disease (ESRD) patients. This investigation assesses the influence of ESRD on clinical manifestations, complications, and outcomes in patients with SEA. Methods: This study retrospectively reviewed medical records of 41 patients with SEA treated during 2003--2006. The patients comprised two groups: group I (patients with ESRD) and group II (patients without ESRD). Patient characteristics, including age, gender, comorbidities, clinical presentations, laboratory data, locations of epidural abscess, and outcome, were recorded and compared. Results: The final sample comprised 41 patients. The mean age of the subjects was 62 ++ 12 years. The sample included 12 patients with ESRD and 29 without ESRD. The development of symptoms was similar for both groups. Group I patients displayed higher serum erythrocyte sedimentation rate (ESR) (108 ++ 26 vs. 81 ++ 31 mm/h, p == 0.014) and lower serum hematocrit (27.1 ++ 4.3 vs. 33.7 ++ 5.1%%, p < 0.001) than group II patients. Overall survival at 3 months was 88.9%% and 93.1%% for patients in groups I and II, respectively (p == 0.876). Meanwhile, patients that underwent surgical decompression of epidural abscess received more surgeries than group I patients (1.08 vs. 0.55, p == 0.086), although the difference was not significant. Conclusions: ESRD is a risk factor for repeat surgery in patients with SEA. This investigation suggests that ESRD patients with SEA may require aggressive surgical intervention despite ESRD not affecting their long-term prognosis.</.

• 出版日期2011
• 单位长春大学