Temporal trends in incidence, clinical characteristics and outcomes of pyogenic vertebral osteomyelitis in Southern Denmark from 2009 to 2022: a retrospective population-based cohort study.
7 affiliations
- 1Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.
- 2Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
- 3Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.
- 4Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
- 5Department of Internal Medicine, Infectious Diseases Unit, Zealand University Hospital, Roskilde, Denmark.
- 6Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.
- 7Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark.
Abstract
Objectives
Pyogenic vertebral osteomyelitis (PVO) is a severe infection with increasing incidence. We aimed to describe long-term population-based temporal trends in incidence, clinical presentation, diagnostic approaches, microbiology, and outcomes.Materials and methods
We conducted a retrospective population-based cohort study including 1,017 adults with multidisciplinary team-verified PVO diagnosed at a tertiary infectious diseases referral centre in the Region of Southern Denmark between 2009 and 2022. Incidence rates (IRs) per 100,000 person-years (PY) were calculated using regional population data and compared across three calendar periods (2009-2013, 2014-2018, 2019-2022). Temporal changes in clinical characteristics, microbiology, diagnostic strategies, and outcomes were assessed.Results
In total, 1,017 patients were included. The crude IR increased from 4.7 per 100,000 PY in 2009-2013 to 11.0 in 2019-2022, with the largest increase among patients aged ≥70 years. Mean age and comorbidity burden rose over time. Pain was common, fever was often absent, and neurological deficits occurred in 33.5% (n = 341). Postsurgical infection was the most frequent primary focus, and concomitant endocarditis occurred in 8.3% (n = 84). A microbiological diagnosis was established in 64.8% (n = 635) of cases, most commonly Staphylococcus aureus. Use of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography ([¹⁸F]FDG-PET/CT) increased over time. Median hospital stay remained 33 days. One-year mortality increased from 9.5% to 18.2%, while relapse declined, resulting in a stable composite risk of death or relapse (20.7%).Conclusions
The incidence of PVO increased markedly from 2009 to 2022, predominantly in older patients with comorbidities. Despite improved diagnostics, microbiologically-negative cases remain frequent. Mortality remained high and increased over time.
Related
- Clinical Complexity in Native Vertebral Osteomyelitis: Exploring the Role of Rurality—A Retrospective Cohort Study
- Hematogenous vertebral osteomyelitis caused by vaginal microbiota: metagenomic resolution of a polymicrobial anaerobic case
- Incidence, characteristics, and exploratory analysis of factors associated with pelvic osteitis/osteoradionecrosis after radiotherapy for cervical cancer: a single-center retrospective cohort study with an unmatched case-control analysis
- Clinical characteristics and prognosis of T1N0M1 lung cancer: a population-based retrospective study
- Epidemiological Characteristics and Incidence Trends of Hemorrhagic Fever With Renal Syndrome in Shandong Province, China: Retrospective Observational Study With Forecasting
BibTeX
@article{lindvig2026temporal,
title = {{Temporal trends in incidence, clinical characteristics and outcomes of pyogenic vertebral osteomyelitis in Southern Denmark from 2009 to 2022: a retrospective population-based cohort study.}},
author = {Susan Olaf Lindvig and Michala Kehrer and Inge Petersen and Søren Hess and Zahra Persson Theilgaard and Flemming Schønning Rosenvinge and Isik Somuncu Johansen},
journal = {Annals of medicine},
year = {2026},
month = oct,
doi = {10.1080/07853890.2026.2738249},
url = {https://europepmc.org/article/MED/42902785},
note = {CC BY},
}
RIS
TY - JOUR
TI - Temporal trends in incidence, clinical characteristics and outcomes of pyogenic vertebral osteomyelitis in Southern Denmark from 2009 to 2022: a retrospective population-based cohort study.
AU - Susan Olaf Lindvig
AU - Michala Kehrer
AU - Inge Petersen
AU - Søren Hess
AU - Zahra Persson Theilgaard
AU - Flemming Schønning Rosenvinge
AU - Isik Somuncu Johansen
PY - 2026
DA - 2026/10/21
JO - Annals of medicine
DO - 10.1080/07853890.2026.2738249
UR - https://europepmc.org/article/MED/42902785
AB - Objectives Pyogenic vertebral osteomyelitis (PVO) is a severe infection with increasing incidence. We aimed to describe long-term population-based temporal trends in incidence, clinical presentation, diagnostic approaches, microbiology, and outcomes.Materials and methods We conducted a retrospective population-based cohort study including 1,017 adults with multidisciplinary team-verified PVO diagnosed at a tertiary infectious diseases referral centre in the Region of Southern Denmark between 2009 and 2022. Incidence rates (IRs) per 100,000 person-years (PY) were calculated using regional population data and compared across three calendar periods (2009-2013, 2014-2018, 2019-2022). Temporal changes in clinical characteristics, microbiology, diagnostic strategies, and outcomes were assessed.Results In total, 1,017 patients were included. The crude IR increased from 4.7 per 100,000 PY in 2009-2013 to 11.0 in 2019-2022, with the largest increase among patients aged ≥70 years. Mean age and comorbidity burden rose over time. Pain was common, fever was often absent, and neurological deficits occurred in 33.5% (n = 341). Postsurgical infection was the most frequent primary focus, and concomitant endocarditis occurred in 8.3% (n = 84). A microbiological diagnosis was established in 64.8% (n = 635) of cases, most commonly Staphylococcus aureus. Use of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography ([¹⁸F]FDG-PET/CT) increased over time. Median hospital stay remained 33 days. One-year mortality increased from 9.5% to 18.2%, while relapse declined, resulting in a stable composite risk of death or relapse (20.7%).Conclusions The incidence of PVO increased markedly from 2009 to 2022, predominantly in older patients with comorbidities. Despite improved diagnostics, microbiologically-negative cases remain frequent. Mortality remained high and increased over time.
SN - 0785-3890
SN - 1365-2060
ER -