An international consensus based on the Delphi method to define failure of medical treatment in pyogenic spinal infections

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dc.contributor.authorUrrutia, Julio
dc.contributor.authorCamino-Willhuber, Gaston
dc.contributor.authorGuerrero, Alonso
dc.contributor.authorDiaz-Ledezma, Claudio
dc.contributor.authorBono, Christopher M.
dc.date.accessioned2025-01-20T17:08:29Z
dc.date.available2025-01-20T17:08:29Z
dc.date.issued2024
dc.description.abstractBACKGROUND CONTEXT: Pyogenic spinal infections (PSIs) are severe conditions with high morbidity and mortality. If medical treatment fails, patients may require surgery, but there is no consensus regarding the definition of medical treatment failure. PURPOSE: To determine criteria for defining failure of medical treatment in PSI through an international consensus of experts. STUDY DESIGN: A two -round basic Delphi method study. SAMPLE: One hundred and fifty experts from 22 countries (authors or co-authors of clinical guidelines or indexed publications on the topic) were invited to participate; 33 answered both rounds defining the criteria. OUTCOME MEASURES: A scale of 1 to 9 (1: no relevance; 9: highly relevant) applied to each criterion. METHODS: We created an online survey with 10 criteria reported in the literature to define the failure of medical treatment in PSIs. We sent this survey via email to the experts. Agreement among the participants on relevant criteria (score >= 7) was determined. One month later, the second round of evaluations was sent. An extra criterion suggested by six responders in the first round was incorporated. The final version was reached with the criteria considered relevant and with high agreement. RESULTS: The consensus definition is: (1) There is an uncontrolled sepsis despite broad spectrum antibiotic treatment, and (2) There is an infection relapse, following a six -week period of antibiotics with clinical and laboratory improvement. CONCLUSIONS: Our definition of failure following nonsurgical treatment of PSI can offer a standardized approach to guide clinical decision -making. Furthermore, it has the potential to enhance scientific reporting within this field. (c) 2023 Elsevier Inc. All rights reserved.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.spinee.2023.09.018
dc.identifier.eissn1878-1632
dc.identifier.issn1529-9430
dc.identifier.urihttps://doi.org/10.1016/j.spinee.2023.09.018
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/90955
dc.identifier.wosidWOS:001170987400001
dc.issue.numero2
dc.language.isoen
dc.pagina.final255
dc.pagina.inicio250
dc.revistaSpine journal
dc.rightsacceso restringido
dc.subjectDelphi method
dc.subjectInternational consensus
dc.subjectPyogenic spinal infections
dc.subjectVertebral osteomyelitis
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleAn international consensus based on the Delphi method to define failure of medical treatment in pyogenic spinal infections
dc.typeartículo
dc.volumen24
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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