Introduction
Septic arthritis (SA) is considered a medical emergency due to its high morbidity and mortality.
Objective
Determine short-term (<90 days) mortality predictor factors (MPF) in SA and report postoperative adverse events at 1 year.
Materials And Methods
Retrospective cohort of 126 adults (16 to 92 years), with SA treated at a Santiago Public Hospital, between 2013 and 2024. Data were obtained from surgical protocols of patients diagnosed with SA. Sociodemographic and clinical history, primary (arthrocentesis > 50,000 leukocytes and/or microbiological with gram or positive cultures) or secondary (sepsis/septic shock on admission) diagnosis of Knee SA, shoulder and/or hip, in-hospital mortality and number of adverse events per year were recorded. Patients <15 years of age, periprosthetic infections, and previous joint surgery were excluded. We performed a descriptive statistical analysis, using t-Student to compare continuous variables and chi-square for categorical variables and ridge regression to identify risk factors associated with mortality <90 days, with their respective CI (95%) and p<0.05. The analyses were performed using the R program version 1.4.1106.
Results
The mortality rate <90 days was 10.3% (13 patients)(Table 1). Among the Mortality Predictor Factors (MPF) we observed sepsis/septic shock at admission (OR 27.15; CI 9.71-58.6;p<0.05), ≥60 years (OR 2.3; CI 1.04-6.62 ;p<0.05) and SA in shoulder (OR 4.03; CI 1.36-13.50;p<0.05). At one-year follow-up, 8.8% (10 patients) had osteomyelitis, 2.7% (3) arthrodesis and 0.9% (1) amputation, with no impact on mortality (p>0.05) (Table 2).
Conclusion
The results suggest that sepsis/septic shock on admission, age ≥60 years, and having glenohumeral involvement are associated with higher mortality <90 days in patients with SA. Osteomyelitis was the most frequent complication at 1 year.
Keywords: septic arthritis, mortality, sepsis, septic shock.