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A 10 year descriptive audit of spinal infections managed at Christchurch Hospital

A 2019/2020 Summer Studentship research project

An improved understanding of local epidemiology of spinal infections as well as patient outcomes in preparation for applying the results of the OVIVA study to this clinical condition and enable re-audit at a later date.

Student: Danielle Bucknall
Supervisors: Dr Sarah Metcalf, Dr Simon Dalton, Dr Alan Pithie, Professor Steve Chambers, Kate Gallagher
Sponsor: Canterbury District health Board, Department of Infectious Diseases

Introduction

Spinal infections are infrequent but carry significant morbidity to patients. They may be subdivided into several discrete categories. The microbiology is quite varied and in many cases there may be no confirmed microbiology. Treatment is traditionally 6–8 weeks of intravenous antibiotics, however recently the OVIVA trial has reported non-inferior treatment outcomes for an array of bone and joint infections including spinal infections for early switch to PO antibiotics. Treatment failure does occur in spite of prolonged courses of intravenous antibiotics. Understanding potential factors contributing to treatment failure may facilitate patient selection for early PO antibiotics

Aim

This is a retrospective descriptive audit of all spinal infections managed at Christchurch Hospital for 10 years to describe frequency and type of spinal infection, microbiology, treatment, patient outcome including treatment failure. We would also like to assess potential factors which may contribute to treatment failure.

Method

  • Utilise the Home IVAB database plus discharge diagnostic code search to identify all patients treated at Christchurch Hospital over a 10 year period (January 2008 – December 2018)
  • Collate data from electronic patient records using Health Connect South and Éclair databases, Home IVAB database and paper clinical records as required
  • Analyse data using simple descriptive statistics
  • Assess potential risk factors for treatment failure with the using appropriate statistical tests using univariate and multivariate analyses

Student researcher’s component of the study

  • We will identify cases from our Home IVAB database and diagnostic code search prior to the student commencing
  • The student will complete all data entry into an excel spreadsheet including demographics (age, gender, ethnicity), category of spinal infection (discitis, vertebral osteomyelitis, septic facet joint arthritis, epidural abscess), microbiology (if identified), comorbidity, treatment received (surgery, antimicrobials including duration of IV and PO components of antimicrobial treatment), reported patient outcomes, treatment failure, mortality within 12 months of treatment
  • The student will work with the supervisors to undertake the statistical analyses on the completed data set
  • The student will participate in preparing a manuscript for publication

Student Prerequisites

Medical Student

How to apply

Email Simon.Dalton@cdhb.health.nz