scholarly journals Occurrence of Surgical Site Infections at a Tertiary Healthcare Facility in Abuja, Nigeria: A Prospective Observational Study

2018 ◽  
Vol 6 (3) ◽  
pp. 60 ◽  
Author(s):  
Ahmed Olowo-okere ◽  
Yakubu Ibrahim ◽  
Ali Sani ◽  
Busayo Olayinka
Keyword(s):  
Kirschner Wire ◽  
Surgical Site Infections ◽  
Exploratory Laparotomy ◽  
Healthcare Facility ◽  
The United States ◽  
Multivariate Logistic Regression Model ◽  
P Value ◽  
Surgical Interventions ◽  
Co Morbidity ◽  
Tertiary Healthcare

Surgical site infection (SSI) is one of the most frequent complications of surgical interventions. Several factors have been identified as major determinants of occurrence of SSIs. The present study determined the occurrence and possible risk factors associated with SSIs at a tertiary healthcare facility in Abuja, Nigeria. All patients scheduled for operation in the hospital during the study period and who consented to participate willingly in the study were observed prospectively for the occurrence of SSI based on criteria stipulated by the United States Centre for Disease Control and Prevention (CDC). Data on sociodemographic characteristics, lifestyle, surgical procedure and co-morbidity were collected into a pre-tested data collection tool and analysed using IBM SPSS Statistics software v.24. Predictors of SSIs were identified using multivariate logistic regression model and p-value less than 0.05 was considered statistically significant. Of the 127 surgical patients that met the inclusion criteria comprising 65 (51.2%) females and 62 (48.8%) males between 1 and 83 years with mean age of 25.64 ± 1.66 years, 35 (27.56%; 95% Confidence Interval (CI): 0.205–0.360) developed SSIs. Prolonged post-operative hospital stays (p < 0.05), class of wound (p < 0.0001) and some comorbid conditions were found to be significantly associated with higher SSI rate. The SSI rate was highest among patients that had Kirschner-wire insertion (75.0%), followed by an unexpectedly high infection rate among patients that had mastectomy (42.9%), while lower percentages (33.3%) were recorded among patients that had exploratory laparotomy and appendicectomy. The overall magnitude of SSIs in this facility is high (27.6%; 95% CI: 0.205–0.360). Several factors were found to be independent predictors of occurrence of SSI. The findings thus highlight the need for improved surveillance of SSIs and review of infection control policies of the hospital.

scholarly journals Effect of thrombocytopenia in patients with infective endocarditis: an insight from the National Inpatient Sample database

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
N Patel ◽  
B Amgai ◽  
S Chakraborty ◽  
A Hajra ◽  
K Ashish ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Multivariate Logistic Regression Analysis ◽  
The United States ◽  
P Value ◽  
National Inpatient Sample ◽  
Pronounced Increase ◽  
Propensity Match ◽  
Co Morbidity ◽  
The Difference ◽  
Poor Outcomes

Abstract Introduction Infective endocarditis (IE) is one of the feared diseases in septic patients, and incidences are rising due to the intravenous drug abuse epidemic. Sepsis causes an escalation of the platelet destructions leading to thrombocytopenia (1). Few independent hospital-based studies have proposed increase mortality with thrombocytopenia in patients with IE (2–5). We aim to evaluate the significance of thrombocytopenia in IE subjects from the national inpatient sample (NIS) database. Method We analyzed the NIS database from Jan-2016 to Dec-2018 using Stata 16.0. NIS is the largest publicly available all-payer inpatient care database in the United States, containing data on more than seven million hospital stays per year. We identified patients with IE with or without thrombocytopenia using ICD-10 codes. The primary outcome of interest was in-hospital mortality comparison. We adjusted potential confounders (age, sex, diabetes, hypertension, etc.) with multivariate logistic regression analysis. Further analysis was done after balancing the population co-morbidity using a Greedy propensity match for accuracy. Results A total of 174,495 subjects were included in this study with a diagnosis of IE. Among these individuals, 33,285 patients had a concurrent diagnosis of thrombocytopenia. The mean ages were 53±19.5 years for the thrombocytopenia group and 55±19.8 years for others. Females were equally represented in both cohorts. There were 4,945 (14.86%) vs 2,835 (2.01%) mortalities reported in with and without thrombocytopenia group respectively. After propensity matching, there was a pronounced increase in mortality [Odds ratio (OR): 1.93 (1.72 – 2.15), p-value: &lt;0.001] in the group with thrombocytopenia comparing to others. Complications such as Major bleeding requiring blood transfusion [OR: 1.45 (1.35–1.57)], acute myocardial infarction [OR: 1.56 (1.35–1.70)], complete heart block [OR: 1.44 (1.16–1.53)], cardiac arrest [OR: 1.44 (1.25–1.72)], acute respiratory failure [OR: 1.51 (1.39–1.73)] and pressor support requirement [(OR: 1.73 (1.57–2.01)] were notably higher in the cohort of thrombocytopenia with statistically significant p-value (&lt;0.001). The difference in length of stay between both cohorts after propensity match wasn't statistically significant. Conclusion In conclusion, IE patients with thrombocytopenia have higher incidences of in-patient mortality and poor outcomes than cohort without thrombocytopenia. Some of the adverse consequences could be temporally explained by complications related to underlying thrombocytopenia. Further investigations are needed to delineate the outcome in this group of subjects. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Role of Computed Tomography in Predicting Severity of Acute Pancreatitis

2020 ◽  
Vol 11 (3) ◽  
pp. 4039-4046
Author(s):  
Kapil P. Sawarkar ◽  
Pramod Shah
Keyword(s):  
Computed Tomography ◽  
Severity Index ◽  
Healthcare Facility ◽  
Study Data ◽  
Radiology Department ◽  
Cross Sectional ◽  
Surgical Interventions ◽  
Pancreatic Fluid ◽  
Necrotic Pancreatitis ◽  
Tertiary Healthcare

The current study was based on Computed Tomography (CT) findings and results. We found 63% of patients with acute interstitial edematous pancreatitis, and we found 37% of patients with acute necrotic pancreatitis in 46 cases. Based on our findings, we observed bulky pancreas among 26 cases (56.52%), 17 cases (36.95%) of pancreatic necrosis, 9 cases of pancreatic atrophy, 11 cases of pseudocyst, and 9 cases of peri-pancreatic fluid. When we evaluated the Modified CT Severity index among the study cases, we observed that 19.56% cases have mild index, the majority (56.52% cases) have moderate index while 23.91% have severe index. We also found that majority of the cases were clinically cured and discharged, i.e., 47.82%. 19.56% of the total study subjects reported recurrence of episodes of pancreatitis, while 30.43% of the total patients turned into chronic pancreatitis. This study presents a cross-sectional hospital-based analytical study carried out among 46 cases of AP referred to under the radiology department for further diagnostic evaluation, in a tertiary healthcare facility in Maharashtra. The present study Data Source included all the AP patients referred to the radiological department in a tertiary health research center. They met the standards for inclusiveness, which assented to the analysis. Type of study is Hospital analytical based study. The study duration is 18 months. Data collection was done through semi-structured, pre-designed, and pre-validated proformas in patients meeting inclusion requirements that included disease history, clinical outcomes, investigative records, and descriptions of surgical interventions.

scholarly journals Magnitude of Surgical Site Infection and Its Associated Factors Among Patients Who Underwent a Surgical Procedure at Debre Tabor General Hospital, Northwest Ethiopia

2020 ◽  
Author(s):  
Mequanint Bezie Walelign ◽  
Tadesse Wuletaw Demissie ◽  
Abaynew Honelign Desalegn
Keyword(s):  
Surgical Site Infection ◽  
General Hospital ◽  
Surgical Procedure ◽  
Surgical Site Infections ◽  
Northwest Ethiopia ◽  
P Value ◽  
Age Group ◽  
Site Infection ◽  
Co Morbidity ◽  
Debre Tabor

Abstract Background: Surgical site infections are the commonest nosocomial infections and responsible for considerable morbidity and mortality as well as increased hospitalizations and treatment cost related to surgical operations. The aim of this study was to determine the magnitude and factors associated with surgical site infections at the surgical ward of Debre Tabor General Hospital, Northwest Ethiopia.Method: Institution based cross-sectional study was conducted on patients who underwent a surgical procedure at Debre Tabor General Hospital in 2020. The sample size was determined using the single population proportion formula. Data were entered and analyzed using SPSS version 21 software. Bivariate and multivariate logistic regressions analysis were employed. The odds ratio and its 95% confidence interval were taken to test the association between the dependent and independent variables. A P-value of less than 0.05 will be considered statistically significant.Result: In this study, a total of 191 patients have participated in the study yielding a response rate of 100%. The mean age of the respondents was 2.5 (SD ±0.68) years. The most age group 115(60.2%) resides at the age group greater than 40 years. More than one half(62.3) of the surgical clients were females. Most of the clients were farmers(32.5%) and unable to read and write(41.9) based on the occupation. The magnitude of surgical site infection in this study was found to be 11.5% (95% CI: 7.8%, 15.9%). The factors existence of comorbidity and antibiotic prophylaxis was given were found to be significantly associated with the magnitude of surgical site infection.Conclusion: The magnitude of surgical site infection in this study was high. Proper management of patients with co-morbidity especially those with diabetes mellitus, proper administration of anesthesia, and delivering intravenous antimicrobial prophylaxis before surgery as ordered would significantly reduce the incidence of surgical site infection.

The Cost of Surgical Site Infections after Colorectal Surgery in the United States from 2001 to 2012: A Longitudinal Analysis

2019 ◽  
Vol 85 (2) ◽  
pp. 142-149 ◽  
Author(s):  
Owen Gantz ◽  
Pavel Zagadailov ◽  
Aziz M. Merchant
Keyword(s):  
United States ◽  
Colorectal Surgery ◽  
Healthcare Cost ◽  
Surgical Site Infections ◽  
The United States ◽  
Cost Burden ◽  
National Inpatient Sample ◽  
Infection Rates ◽  
Surgical Interventions ◽  
The Cost

Surgical site infections (SSIs) are among the most common types of postoperative complications in the United States and are associated with significant prevalence of morbidity and mortality in patients undergoing surgical interventions, especially in colorectal surgery (CRS) where SSI rates are significantly higher than those of similar operative sites. SSIs were identified from the National Inpatient Sample-Healthcare Cost and Utilization Project database from 2001 to 2012 based on the specification of an ICD-9 code. Propensity score matching was used to compare costs associated with SSI cases with those of non-SSI controls among elective and nonelective admissions. Results were projected nationally using Healthcare Cost and Utilization Project sampling methodology to evaluate the incidence of SSIs and ascertain the national cost burden retrospectively. Among 4,851,359 sample-weighted hospitalizations, 4.2 per cent (203,597) experienced SSI. Elective admissions associated with SSI-stayed hospitalized for an average of 7.8 days longer and cost $18,410 more than their counterparts who did not experience an SSI. Nonelective admissions that experienced an SSI had an 8.5-day longer hospital stay and cost $20,890 more than counterparts without perioperative infections. This represents a 3 per cent annual growth in costs for SSIs and seems to be largely driven by cost increases in treatment of SSIs for elective surgeries. Current efforts of SSI management after CRS focused on compliance with guidelines and tracking of infection rates would benefit from some improvements. Considering the growing costs and increase in resource utilization associated with SSIs from 2001 to 2012, further research on costs associated with management of SSIs specific to CRS is necessary.

scholarly journals Magnitude of Surgical Site Infection and its Associated Factors among Patients who Underwent a Surgical Procedure at Debre Tabor General Hospital, Northwest Ethiopia

2020 ◽  
Author(s):  
Mequanint Bezie Walelign ◽  
Tadesse Wuletaw Demissie ◽  
Abaynew Honelign Dessalegn
Keyword(s):  
Surgical Site Infection ◽  
General Hospital ◽  
Surgical Procedure ◽  
Surgical Site Infections ◽  
Northwest Ethiopia ◽  
P Value ◽  
Age Group ◽  
Site Infection ◽  
Co Morbidity ◽  
Debre Tabor

Abstract Background: Surgical site infections are commonest nosocomial infections and responsible for considerable morbidity and mortality as well as increased hospitalizations and treatment cost related to surgical operations.Objective: The aim of this study was to determine the magnitude and factors associated with surgical site infections at surgical ward of Debre Tabor General Hospital, Northwest Ethiopia.Method: Institution based cross sectional study was conducted on patients who underwent a surgical procedure at Debre Tabor General Hospital in 2020. The sample size was determined using single population proportion formula. Data were entered and analyzed using SPSS version 21 software. Bivariate and multivariate logistic regressions analysis were employed. Odds ratio and its 95% confidence interval were taken to test the association between the dependent and independent variables. P-value of less than 0.05 will be considered as statistically significant. Result: In this study, a total of 191 patients have participated in the study yielding a response rate of 100%. The mean age of the respondents was 2.5 (SD ±0.68) years. The most age group 115(60.2%) resides at the age group greater than 40 years. More than one half(62.3) of the surgical clients were females. Most of the clients were farmers(32.5%) and un able to read and write(41.9) based on the occupation. The magnitude of surgical site infection in this study was found to be 11.5% (95% CI: 7.8%, 15.9%).The factors existance of comorbidity and antibiotic prophylaxis given were found to be significantly assoiated with magnitude of surgical site infection.Conclusion: The magnitude of surgical site infection in this study was high. Proper management of patients with co-morbidity especially those with diabetes mellitus, proper administration of anesthesia and delivering intravenous antimicrobial prophylaxis before surgery as ordered would significantly reduce the incidence of surgical site infection.

scholarly journals Sick Leaves Pattern in A Tertiary Healthcare Facility in Saudi Arabia

2020 ◽  
Author(s):  
Kossay Abdelhamid Ali Elabd ◽  
Abdullah Alkhenizan ◽  
Abdullah S. Aldughaither
Keyword(s):  
Influenza Vaccine ◽  
Healthcare Facility ◽  
Cross Sectional Study ◽  
Healthcare Organization ◽  
P Value ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Tertiary Healthcare ◽  
Absence Rate ◽  
One Year

Abstract BACKGROUND : Frequent sick leaves in any healthcare organization is a critical problem that can undermine the patients' care. METHODS : This is a quantitative cross-sectional study looking at the frequency of sick leaves among employees of a large, tertiary healthcare facility in Riyadh. We randomly selected 474 employees, who were seen in family medicine clinics during one-year period. We collected all the data retrospectively from their electronic medical records. Then we reviewed and analyzed all the data using SPSS software. RESULTS : There was no difference in the sick leaves rate between males and females (P-value 0.8618), but we saw a higher rate among younger employees (40 years old or less) compared to those 41 years or older (p-value <0.0001). We also investigated those who took four sick leaves or more during the period of the study, and we found that most of them were mainly nursing staff (31.71%), hospital assistances (24.39%) and housekeepers (14.63%). The commonest cause for taking sick leave in our study was viral upper respiratory tract infection. Therefore, we studied the effect of influenza vaccine on the frequency of sick leaves and we found that those who took the vaccine were less likely to take a leave because of flu (P-value <0.0001, Odd ratio 0.4067 with 95% CI 0.2739-0.608). CONCLUSION : younger employees, nurses, hospital assistants and housekeepers are more likely to take sick leaves. These findings need to be studied further in the future to help us dealing with the problem of absenteeism. Flu is the leading cause for sick leaves and influenza vaccine seemed to reduce its rate. In this study, we also discussed different methods that can be used by any healthcare organization to reduce absence rate.

scholarly journals 304. Predictors of mortality in carbapenem-resistant Enterobacteriales bacteremia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S150-S150
Author(s):  
Michael R Hovan ◽  
Vanessa Cedarbaum ◽  
Thomas Kirn ◽  
Thomas Kirn
Keyword(s):  
Mortality Rate ◽  
Healthcare Facility ◽  
Antibiotic Use ◽  
The United States ◽  
Empiric Therapy ◽  
Carbapenem Resistant ◽  
Increased Risk ◽  
Threat Level ◽  
Infection Source ◽  
Microbiological Data

Abstract Background Carbapenem-Resistant Enterobacteriales (CRE) bacteremia is associated with significant morbidity and mortality. CRE were assigned a threat level of “urgent” in the 2019 CDC report on antibiotic resistance in the United States. We attempted to identify predictors of 30-day mortality in patients with CRE bacteremia. Methods We performed a chart review of 146 patients with CRE bacteremia from January 2010 - July 2019. CRE was defined using the current CDC definition. Electronic medical records were reviewed to obtain clinical characteristics and outcomes including prior antibiotic use, comorbidities, prior location, treatment, hospital course, microbiological data and outcomes including in-hospital mortality. Results Of 146 patients included for analysis, the overall 30-day mortality rate was 36.3%. Patients admitted from a healthcare facility including outside hospitals, rehab, nursing homes, and LTACs had a 49.1% (29/59) 30-day mortality rate compared to 27.5% (24/87) for those admitted from home (RR=1.78, 95% CI 1.16–2.73, p=.0082). Patients with a Pitt bacteremia score ≥ 4 had a greater 30-day mortality rate (42.6%, 26/61) compared to those with a Pitt bacteremia score &lt; 4 (17.6%, 15/85) (RR=2.92, 95% CI 1.40–4.16, p=.0015). Patients that received inactive empiric therapy had a 30-day mortality rate of 36% (36/100) compared to 36.9% (17/46) in those that received active empiric therapy (RR=.9741, 95% CI .6155-1.59, p=.9109). Patients with isolates determined to have a meropenem MIC ≥ 4 had a 30-day mortality rate of 40.2% (37/92) while those with an MIC &lt; 4 had a 30-day mortality rate of 30.2% (16/53) (RR=1.33, 95% CI .8250–2.1513, p=.2408). A pulmonary source of bacteremia was associated with an increased risk of 30-day mortality (64.3%, 9/14) compared to all other sources of bacteremia (34.8%, 31/89) (RR=1.85, 95% CI 1.39–2.99, p=.0129). No other infection source was associated with an increased 30-day mortality rate. Conclusion Admission from a healthcare facility, Pitt bacteremia score ≥ 4, and pulmonary source of bacteremia were associated with increased risk of 30-day mortality. Interestingly, administration of active empiric therapy was not associated with a decreased mortality risk. Meropenem MIC was not predictive of 30-day mortality. Disclosures All Authors: No reported disclosures

scholarly journals Liver Impairment and Hematological Changes in Patients with Chronic Hepatitis C and COVID-19: A Retrospective Study after One Year of Pandemic

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 597
Author(s):  
Bianca Cerbu ◽  
Stelian Pantea ◽  
Felix Bratosin ◽  
Iulia Vidican ◽  
Mirela Turaiche ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Clinical Outcomes ◽  
Chronic Hepatitis C ◽  
Hcv Infection ◽  
Multivariate Logistic Regression Model ◽  
P Value ◽  
Liver Impairment ◽  
All Cause Mortality ◽  
Chronic Hcv

Background and Objectives: The COVID-19 pandemic is an ongoing public health emergency. Patients with chronic diseases are at greater risk for complications and poor outcomes. The objective of this study was to investigate the liver function abnormalities and clinical outcomes in patients with COVID-19 and chronic hepatitis C. Materials and Methods: This retrospective, single-center study was conducted on a cohort of 126 patients with a history of hepatitis C, confirmed with COVID-19 between 01 April 2020 and 30 December 2020. Several clinical outcomes were compared between patients with active and non-active HCV infection, and the risks of liver impairment and all-cause mortality in active HCV patients were analyzed using a multivariate logistic regression model. Results: Among 1057 patients under follow-up for chronic HCV infection, 126 (11.9%) were confirmed with COVID-19; of these, 95 (75.4%) were under treatment or achieved SVR, while in the other 31 (24.6%), we found active HCV replication. There was a significantly higher proportion of severe COVID-19 cases in the active HCV group as compared to the non-active HCV group (32.2 vs. 7.3%, p < 0.001). Multivariate analysis showed that age, sex, alanine aminotransferase, C-reactive protein, procalcitonin, and HCV viral load were significant independent risk factors for liver impairment and all-cause mortality. The length of stay in hospital and intensive care unit for COVID-19 was significantly higher in patients with active HCV infection (p-value < 0.001), and a higher proportion of these patients required mechanical ventilation. Conclusions: Active HCV infection is an independent risk factor for all-cause mortality in COVID-19 patients.

scholarly journals Aggressive Colonization Screening and Infection Control Measures in Containment of NDM-5 Carbapenemase-Producing CRE

2020 ◽  
Vol 41 (S1) ◽  
pp. s458-s459
Author(s):  
Ishrat Kamal-Ahmed ◽  
Kate Tyner ◽  
Teresa Fitzgerald ◽  
Heather Adele Moulton-Meissner ◽  
Gillian McAllister ◽  
...  
Keyword(s):  
Public Health ◽  
Infection Control ◽  
Acute Care Hospital ◽  
Healthcare Facility ◽  
The United States ◽  
Control Measures ◽  
Care Hospital ◽  
Clinical Culture ◽  
Medical Histories ◽  
Asymptomatic Case

Background: In April 2019, Nebraska Public Health Laboratory identified an NDM-producing Enterobacter cloacae from a urine sample from a rehabilitation inpatient who had recently received care in a specialized unit (unit A) of an acute-care hospital (ACH-A). After additional infections occurred at ACH-A, we conducted a public health investigation to contain spread. Methods: A case was defined as isolation of NDM-producing carbapenem-resistant Enterobacteriaceae (CRE) from a patient with history of admission to ACH-A in 2019. We conducted clinical culture surveillance, and we offered colonization screening for carbapenemase-producing organisms to all patients admitted to unit A since February 2019. We assessed healthcare facility infection control practices in ACH-A and epidemiologically linked facilities by visits from the ICAP (Infection Control Assessment and Promotion) Program. The recent medical histories of case patients were reviewed. Isolates were evaluated by whole-genome sequencing (WGS). Results: Through June 2019, 7 cases were identified from 6 case patients: 4 from clinical cultures and 3 from 258 colonization screens including 1 prior unit A patient detected as an outpatient (Fig. 1). Organisms isolated were Klebsiella pneumoniae (n = 5), E. cloacae (n = 1), and Citrobacter freundii (n = 1); 1 patient had both NDM-producing K. pneumoniae and C. freundii. Also, 5 case patients had overlapping stays in unit A during February–May 2019 (Fig. 2); common exposures in unit A included rooms in close proximity, inhabiting the same room at different times and shared caregivers. One case-patient was not admitted to unit A but shared caregivers, equipment, and devices (including a colonoscope) with other case patients while admitted to other ACH-A units. No case patients reported travel outside the United States. Screening at epidemiologically linked facilities and clinical culture surveillance showed no evidence of transmission beyond ACH-A. Infection control assessments at ACH-A revealed deficiencies in hand hygiene, contact precautions adherence, and incomplete cleaning of shared equipment within and used to transport to/from a treatment room in unit A. Following implementation of recommended infection control interventions, no further cases were identified. Finally, 5 K. pneumoniae of ST-273 were related by WGS including carriage of NDM-5 and IncX3 plasmid supporting transmission of this strain. Further analysis is required to relate IncX3 plasmid carriage and potential transmission to other organisms and sequence types identified in this study. Conclusions: We identified a multiorganism outbreak of NDM-5–producing CRE in an ACH specialty care unit. Transmission was controlled through improved infection control practices and extensive colonization screening to identify asymptomatic case-patients. Multiple species with NDM-5 were identified, highlighting the potential role of genotype-based surveillance.Funding: NoneDisclosures: Muhammad Salman Ashraf reports that he is the principal investigator for a study funded by an investigator-initiated research grant.

scholarly journals POS0942 THE NEGATIVE IMPACT OF UNDIAGNOSED DEPRESSION IN AXIAL SPONDYLOARTHROPARTHY: RESULTS OF A SCREENING STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 734.1-734
Author(s):  
S. Maguire ◽  
F. B. O’shea
Keyword(s):  
Disease Activity ◽  
Negative Impact ◽  
Depression Scale ◽  
Clinic Visit ◽  
Categorical Variables ◽  
P Value ◽  
Continuous Variables ◽  
Numerical Result ◽  
Co Morbidity ◽  
Patient Reported

Background:Previous research in axial spondyloarthropathy(axSpA) has shown this population to have a high prevalence of depression. This co-morbidity has been previously shown to impact disease activity in patients with rheumatic disease.Objectives:The purpose of this study was to screen for early signs of depression using two validated tools, the Patient Health Questionaire-9 (PHQ-9) and the Hospital Anxiety and Depression Scale for depression (HADs-D) in patients with known axSpA.Methods:AxSpA patients attending the Rheumatology department in St James’ Hospital between February and October 2020 were invited to take a self-administered survey which included the PHQ-9 and the HADs-D. Scores from the HADs-D yielded a numerical result which was then categorised as normal, borderline or abnormal. PHQ-9 numerical results were categorised as normal, mild, moderate, moderate/severe or severe. Patients with a known diagnosis of depression were excluded. In addition to baseline demographics, patient reported outcomes from the clinic visit were also recorded.Data analysis was performed using IBM SPSS version 26. Continuous variables were recorded as means, categorical variables as frequencies with percentages. A one-way analysis of variance analysis (ANOVA) was used to determine significance of variation in outcomes between patient outcomes as determined by the HADs-D and PHQ-9. A p-value of <0.05 was deemed significant. Consent was obtained prior to participation. Approval was received from the St James’/Tallaght Hospital Joint Ethics Committee.Results:In total 71 axSpA patients took part in the survey. The population was 70.4%(50) males and 29.5%(21) female, with an average age 47.9 years and mean disease duration 19.7 years (mean outcomes: BASDAI 4.08, BASFI 3.62, BASMI 3.54, ASQoL 6.79). Overall, 7 (9.9%) participants recorded abnormal HADs-D scores, while 17 (23.9%) recorded moderate to severe PHQ-9 scores indicative of underlying depression. AxSpA females had higher mean HADs-D scores (7.5 vs 4.8, p=0.01) than males, with abnormal scores in 19%(4) of females and 6% (3) of males. No significant differences were found in PHQ-9 scores between genders.Analysis revealed significantly worse BASDAI (6.27 vs 3.42, p<0.01) and AQoL scores (12.57 vs 5.26, p<0.01) in axSpA patients with abnormal compared to normal HADs-D scores. No significant differences were noted in BASFI, BASMI or baseline demographics. A similar pattern was noted on analysis of PHQ-9 scores, with significantly worse BASDAI (7.9 vs 2.55, p<0.01), BASFI (8.05 vs 2.33, p<0.01) and ASQoL (19.5 vs 2.62, p<0.01) noted in those scoring as severe compared to normal. No significant differences were detected in BASMI scores or baseline demographics.Conclusion:A high percentage of axSpA patients recorded high HADs-D and PHQ-9 scores concerning for undiagnosed depression. These patients were noted to have significantly worse disease activity and quality of life as compared to patients with normal scores. Clinicians treating axSpA should consider screening for depression in this population.Disclosure of Interests:Sinead Maguire Speakers bureau: Speaker fee from Jassen, Grant/research support from: Recipient of the Gilead Inflammation Fellowship Grant, Finbar Barry O’Shea: None declared

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