ArticleJournal of acute medicine2023
Spinal Epidural Abscess: Early Suspicion in Emergency Department Using C-Reactive Protein and Erythrocyte Sedimentation Rate Tests.
Article in Journal of acute medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed, 1 citations in OpenAlex.
- An Assessment of C-Reactive Protein and Erythrocyte Sedimentation Rate in Ruling Out Acute Infectious Spinal Pathology in Emergency Department Patients: A Retrospective Cohort Study.Journal of the American College of Emergency Physicians open · 2025Article
- Treatment of Spinal Epidural Abscess With Limited Decompression.Ochsner journal · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Spinal epidural abscess (SEA) is an uncommon but serious differential diagnosis of acute spinal pain with high paralysis and mortality rate. This study aims to provide local data on its bioclinical characteristics and evaluate potential strategies to enhance its diagnostic rate in accident and emergency department (AED). Methods: A retrospective case study from 2013 to 2019 was conducted in United Christian Hospital. SEA cases were classified as study group, spinal pain due to non-SEA cases were classified as control group. Data collected from study group included symptoms, radiological diagnosis, microbiological culture, treatment, and outcome. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) of both groups were compared to analyze their diagnostic power. Results: In the study group (n = 42), 93% of patients had spinal pain, 55% had fever, 60% had neurological deficits, and only 26% had the classic triad on presentation. Seventy-four percent of patients presented with spinal cord or cauda equina compression in their first magnetic resonance imaging. Mortality rate was 23.8%, and paralysis rate was 7.1%. Diagnostic accuracy in AED was 12%. Admission to orthopedic ward (n = 23) resulted in a significantly lower mean time-to-imaging (4.39 days vs. 14.58 days) and mean time-to-treatment (6.56 days vs. 16.9 days) as compared to other specialties. The area under curves of CRP and ESR were 0.893 and 0.874 respectively, the optimal threshold levels were 45.9 mg/L (sensitivity 82.9%, specificity 79%) and 59.5 mm/hr (sensitivity 87.2%, specificity 80.4%), respectively. Conclusion: Diagnosis of SEA in emergency department based on clinical symptomatology is not reliable due to low incidence of the classic triad, despite a more advanced disease on presentation. We proposed incorporating CRP and ESR tests into evaluation of patients with spinal pain since both tests demonstrated excellent discriminative power in diagnosing SEA.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.