Background: Osteomyelitis is an acute or chronic infection of the bone structures which can be caused by either bacteria, fungi, or mycobacteria. Studies have reported a high annual incident of about 1 in 675 hospital admission in the United States. The overall incident is higher in the male population for reasons unclear and increases with age likely due to an increase in the prevalence of comorbidities. Our study aims to investigate the regional and racial characteristics and outcomes of osteomyelitis admission.

Methods: Data were obtained from the Nationwide inpatient sample database (NIS) for 2016 and 2017. The NIS was searched for hospitalized Adult patients with Osteomyelitis as a principal diagnosis and was included using ICD-10 codes. The primary outcome was inpatient mortality. Secondary outcomes include the mean length of stay (LOS), sepsis, and endocarditis. Data analysis with STATA software. Cofounders adjusted with Multivariable logistic and linear regression analysis.

Results: Out of the 116630 Osteomyelitis hospitalizations 18.8%, 21.3%, 40.3%, and 19.4% were admitted to the Northeast, Midwest, South, and West respectively with a mean age ranging from 57 years old in the South to 60 years old in the Northeast. Overall regional inpatient mortality was 0.5%. Compared to the Northeast, there was no statistically significant difference in the adjusted odds ratio for mortality across the regions. There was no statistically significant regional variation on rates of sepsis, septic shock, and endocarditis. The Midwest had the least length of stay compared to other regions with the mean difference of 1 day which is statistically significant.

Conclusions: There was no regional or racial variation on in-hospital mortality, sepsis, septic shock, and endocarditis in patients admitted for osteomyelitis across the US. There was a decrease in length of stay in patients in the Midwest region compared to other regions.

IMAGE 1: Table 1.