Chronic osteomyelitis increases long-term mortality risk in the elderly

A nationwide population-based cohort study

Chien Cheng Huang, Kang Ting Tsai, Shih Feng Weng, Hung Jung Lin, Hung Sheng Huang, Jhi Joung Wang, How-Ran Guo, Chien Chin Hsu

Research output: Contribution to journalArticle

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Abstract

Background: The elderly are predisposed to chronic osteomyelitis because of the immunocompromised nature of aging and increasing number of chronic comorbidities. Chronic osteomyelitis may significantly affect the health of the elderly; however, its impact on long-term mortality remains unclear. We conceived this retrospective nationwide population-based cohort study to address this issue. Methods: We identified 10,615 elderly patients (≥65 years) comprising 965 patients with chronic osteomyelitis and 9650 without chronic osteomyelitis matched at a ratio of 1:10 by age and gender between 1999 and 2010 from the Taiwan National Health Insurance Research Database. The risk of chronic osteomyelitis between the two cohorts was compared by a following-up until 2011. Results: Patients with chronic osteomyelitis had a significantly higher mortality risk than those without chronic osteomyelitis [incidence rate ratio (IRR): 2.29; 95 % confidence interval (CI): 2.01-2.59], particularly the old elderly (≥85 years; IRR: 3.27; 95 % CI: 2.22-4.82) and males (IRR: 2.7; 95 % CI: 2.31-3.16). The highest mortality risk was observed in the first month (IRR: 5.01; 95 % CI: 2.02-12.42), and it remained persistently higher even after 6 years (IRR: 1.53; 95 % CI: 1.13-2.06) of follow-up. Cox proportional hazard regression analysis showed that chronic osteomyelitis [adjusted hazard ratio (AHR): 1.89; 95 % CI: 1.66-2.15], advanced age (≥85 years; AHR: 2.02; 95 % CI: 1.70-2.41), male (AHR: 1.34; 95 % CI: 1.22-1.48), and chronic comorbidities were independent predictors of mortality. Conclusions: This study demonstrated that chronic osteomyelitis significantly increased the long-term mortality risk in the elderly. Therefore, strategies for prevention and treatment of chronic osteomyelitis and concomitant control of chronic comorbidities are very important for the management of the elderly, particularly for a future with an increasingly aged population worldwide.

Original languageEnglish
Article number72
JournalBMC geriatrics
Volume16
Issue number1
DOIs
Publication statusPublished - 2016 Mar 31

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Osteomyelitis
Cohort Studies
Mortality
Confidence Intervals
Population
Incidence
Comorbidity
National Health Programs
Taiwan
Regression Analysis
Databases
Health

All Science Journal Classification (ASJC) codes

  • Geriatrics and Gerontology

Cite this

Huang, C. C., Tsai, K. T., Weng, S. F., Lin, H. J., Huang, H. S., Wang, J. J., ... Hsu, C. C. (2016). Chronic osteomyelitis increases long-term mortality risk in the elderly: A nationwide population-based cohort study. BMC geriatrics, 16(1), [72]. https://doi.org/10.1186/s12877-016-0248-8
Huang, Chien Cheng ; Tsai, Kang Ting ; Weng, Shih Feng ; Lin, Hung Jung ; Huang, Hung Sheng ; Wang, Jhi Joung ; Guo, How-Ran ; Hsu, Chien Chin. / Chronic osteomyelitis increases long-term mortality risk in the elderly : A nationwide population-based cohort study. In: BMC geriatrics. 2016 ; Vol. 16, No. 1.
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abstract = "Background: The elderly are predisposed to chronic osteomyelitis because of the immunocompromised nature of aging and increasing number of chronic comorbidities. Chronic osteomyelitis may significantly affect the health of the elderly; however, its impact on long-term mortality remains unclear. We conceived this retrospective nationwide population-based cohort study to address this issue. Methods: We identified 10,615 elderly patients (≥65 years) comprising 965 patients with chronic osteomyelitis and 9650 without chronic osteomyelitis matched at a ratio of 1:10 by age and gender between 1999 and 2010 from the Taiwan National Health Insurance Research Database. The risk of chronic osteomyelitis between the two cohorts was compared by a following-up until 2011. Results: Patients with chronic osteomyelitis had a significantly higher mortality risk than those without chronic osteomyelitis [incidence rate ratio (IRR): 2.29; 95 {\%} confidence interval (CI): 2.01-2.59], particularly the old elderly (≥85 years; IRR: 3.27; 95 {\%} CI: 2.22-4.82) and males (IRR: 2.7; 95 {\%} CI: 2.31-3.16). The highest mortality risk was observed in the first month (IRR: 5.01; 95 {\%} CI: 2.02-12.42), and it remained persistently higher even after 6 years (IRR: 1.53; 95 {\%} CI: 1.13-2.06) of follow-up. Cox proportional hazard regression analysis showed that chronic osteomyelitis [adjusted hazard ratio (AHR): 1.89; 95 {\%} CI: 1.66-2.15], advanced age (≥85 years; AHR: 2.02; 95 {\%} CI: 1.70-2.41), male (AHR: 1.34; 95 {\%} CI: 1.22-1.48), and chronic comorbidities were independent predictors of mortality. Conclusions: This study demonstrated that chronic osteomyelitis significantly increased the long-term mortality risk in the elderly. Therefore, strategies for prevention and treatment of chronic osteomyelitis and concomitant control of chronic comorbidities are very important for the management of the elderly, particularly for a future with an increasingly aged population worldwide.",
author = "Huang, {Chien Cheng} and Tsai, {Kang Ting} and Weng, {Shih Feng} and Lin, {Hung Jung} and Huang, {Hung Sheng} and Wang, {Jhi Joung} and How-Ran Guo and Hsu, {Chien Chin}",
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Chronic osteomyelitis increases long-term mortality risk in the elderly : A nationwide population-based cohort study. / Huang, Chien Cheng; Tsai, Kang Ting; Weng, Shih Feng; Lin, Hung Jung; Huang, Hung Sheng; Wang, Jhi Joung; Guo, How-Ran; Hsu, Chien Chin.

In: BMC geriatrics, Vol. 16, No. 1, 72, 31.03.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Chronic osteomyelitis increases long-term mortality risk in the elderly

T2 - A nationwide population-based cohort study

AU - Huang, Chien Cheng

AU - Tsai, Kang Ting

AU - Weng, Shih Feng

AU - Lin, Hung Jung

AU - Huang, Hung Sheng

AU - Wang, Jhi Joung

AU - Guo, How-Ran

AU - Hsu, Chien Chin

PY - 2016/3/31

Y1 - 2016/3/31

N2 - Background: The elderly are predisposed to chronic osteomyelitis because of the immunocompromised nature of aging and increasing number of chronic comorbidities. Chronic osteomyelitis may significantly affect the health of the elderly; however, its impact on long-term mortality remains unclear. We conceived this retrospective nationwide population-based cohort study to address this issue. Methods: We identified 10,615 elderly patients (≥65 years) comprising 965 patients with chronic osteomyelitis and 9650 without chronic osteomyelitis matched at a ratio of 1:10 by age and gender between 1999 and 2010 from the Taiwan National Health Insurance Research Database. The risk of chronic osteomyelitis between the two cohorts was compared by a following-up until 2011. Results: Patients with chronic osteomyelitis had a significantly higher mortality risk than those without chronic osteomyelitis [incidence rate ratio (IRR): 2.29; 95 % confidence interval (CI): 2.01-2.59], particularly the old elderly (≥85 years; IRR: 3.27; 95 % CI: 2.22-4.82) and males (IRR: 2.7; 95 % CI: 2.31-3.16). The highest mortality risk was observed in the first month (IRR: 5.01; 95 % CI: 2.02-12.42), and it remained persistently higher even after 6 years (IRR: 1.53; 95 % CI: 1.13-2.06) of follow-up. Cox proportional hazard regression analysis showed that chronic osteomyelitis [adjusted hazard ratio (AHR): 1.89; 95 % CI: 1.66-2.15], advanced age (≥85 years; AHR: 2.02; 95 % CI: 1.70-2.41), male (AHR: 1.34; 95 % CI: 1.22-1.48), and chronic comorbidities were independent predictors of mortality. Conclusions: This study demonstrated that chronic osteomyelitis significantly increased the long-term mortality risk in the elderly. Therefore, strategies for prevention and treatment of chronic osteomyelitis and concomitant control of chronic comorbidities are very important for the management of the elderly, particularly for a future with an increasingly aged population worldwide.

AB - Background: The elderly are predisposed to chronic osteomyelitis because of the immunocompromised nature of aging and increasing number of chronic comorbidities. Chronic osteomyelitis may significantly affect the health of the elderly; however, its impact on long-term mortality remains unclear. We conceived this retrospective nationwide population-based cohort study to address this issue. Methods: We identified 10,615 elderly patients (≥65 years) comprising 965 patients with chronic osteomyelitis and 9650 without chronic osteomyelitis matched at a ratio of 1:10 by age and gender between 1999 and 2010 from the Taiwan National Health Insurance Research Database. The risk of chronic osteomyelitis between the two cohorts was compared by a following-up until 2011. Results: Patients with chronic osteomyelitis had a significantly higher mortality risk than those without chronic osteomyelitis [incidence rate ratio (IRR): 2.29; 95 % confidence interval (CI): 2.01-2.59], particularly the old elderly (≥85 years; IRR: 3.27; 95 % CI: 2.22-4.82) and males (IRR: 2.7; 95 % CI: 2.31-3.16). The highest mortality risk was observed in the first month (IRR: 5.01; 95 % CI: 2.02-12.42), and it remained persistently higher even after 6 years (IRR: 1.53; 95 % CI: 1.13-2.06) of follow-up. Cox proportional hazard regression analysis showed that chronic osteomyelitis [adjusted hazard ratio (AHR): 1.89; 95 % CI: 1.66-2.15], advanced age (≥85 years; AHR: 2.02; 95 % CI: 1.70-2.41), male (AHR: 1.34; 95 % CI: 1.22-1.48), and chronic comorbidities were independent predictors of mortality. Conclusions: This study demonstrated that chronic osteomyelitis significantly increased the long-term mortality risk in the elderly. Therefore, strategies for prevention and treatment of chronic osteomyelitis and concomitant control of chronic comorbidities are very important for the management of the elderly, particularly for a future with an increasingly aged population worldwide.

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U2 - 10.1186/s12877-016-0248-8

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