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Kienesberger, B.
Sternoclavicular abscess: Prognostic factors of a rare, life-threatening disease.
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2018. pp. 32 [OPEN ACCESS]
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Advisor:: Smolle-Juettner Freyja-Maria
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Abstract:: Sternoclavicular septic arthritis with formation of abscesses is a very rare life-threatening disease, making up for only 1 % of cases of septic arthritis. Usually this condition affects patients with accompanying diseases. In most cases repeated debridement and subsequent reconstruction using pedicled muscle flaps is necessary, often resulting in a prolonged course of disease. The aim of this retrospective study was to find factors allowing to estimate prognosis. We analysed 18 cases of sternoclavicular septic arthritis treated between 2005 and 2015 at the Division of Thoracic and Hyperbaric Surgery in Graz. There were 7 male and 11 female patients (mean age: 69 years; range: 41-88); An average of 5 surgical interventions (range: 1-12) was necessary, including pedicled muscle flaps in 10 cases. The mean duration of stay at the Intensive Care Unit of was 7 days (range: 0-40 days) and the mean total duration of inpatient care was 26 days (range: 10-86 days). Obviously, the need for many operations was statistically significant connected with a longer stay. All patients survived. Though there was a wide range of comorbidities (diabetes mellitus: N=7; chronic renal failure: N=2; hepatic cirrhosis: N=3; preexisting infection at other site: N=7), none of them affected prognosis nor did any of the pathological laboratory findings at the time of admission (CRP, leucocytes, albumin, renal or hepatic markers) or gender. The only factor statistically significant correlated with a long in-hospital stay (p<0.05) was higher age, which was also connected with a significantly higher probability for the need for pedicled muscle flaps. In conclusion, the significant co-mobidity usually found in patients with sternoclavicular septic arthritis has no impact on the healing process, which seems to be influenced mainly by the patients age.