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Septic Arthritis and Its Mimics : Assessing the Incidence, Mortality Rate, Cause-of Death and Preventability in a Population-Based Cohort Study

Johansson, Amelia LU ; Bornai, Omid ; Tverring, Jonas LU orcid and Ljungquist, Oskar LU (2026) In Health Science Reports 9(8).
Abstract

Background: Septic arthritis (SA) is considered the most harmful etiology in patients presenting with an acutely painful swollen knee. This study aimed to estimate the incidence, mortality rate, and cause of death among patients diagnosed with SA and compare it to non-infectious causes. Methods: We conducted a population-based observational cohort study in Skåne, southern Sweden, with a population of 1.4 million people. We included adults in the years 2020 and 2021 with cultures obtained at the emergency department from a native knee, where SA was considered a differential diagnosis based on medical chart review. Data on demographics, comorbidities, microbiological etiology, mortality, and treatment were collected. Results: Out of 709... (More)

Background: Septic arthritis (SA) is considered the most harmful etiology in patients presenting with an acutely painful swollen knee. This study aimed to estimate the incidence, mortality rate, and cause of death among patients diagnosed with SA and compare it to non-infectious causes. Methods: We conducted a population-based observational cohort study in Skåne, southern Sweden, with a population of 1.4 million people. We included adults in the years 2020 and 2021 with cultures obtained at the emergency department from a native knee, where SA was considered a differential diagnosis based on medical chart review. Data on demographics, comorbidities, microbiological etiology, mortality, and treatment were collected. Results: Out of 709 knee joint cultures, 60 (8%) cultures were considered SA. The median age of included patients was 71 years (range 19–97) and 67% were men. The incidence of SA was 2.7 cases per 100,000 person-years. Gout and pyrophosphate arthritis were more prevalent than SA (5.7/100,000 person-years and 6.1/100,000 person-years, respectively. The 90-day all-cause mortality rate for SA was 8% (4/51), compared to mortality rates of 4% (5/126) for gout arthritis and 4% (5/139) for pyrophosphate arthritis, respectively. Possibly one death within 90-days was considered directly associated to SA (2%). No deaths were considered preventable due to inadequate antimicrobial therapy or management. Conclusion: We observed a low incidence of native knee SA, with gout and pyrophosphate arthritis occurring twice as frequently. In our cohort, the infection-related mortality from SA was low and considered non-preventable.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
acute monoarthritis, incidence, mortality, native knee septic arthritis, preventability
in
Health Science Reports
volume
9
issue
8
article number
e72845
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:105047361755
  • pmid:42568852
ISSN
2398-8835
DOI
10.1002/hsr2.72845
language
English
LU publication?
yes
id
36e1854a-c43e-477d-b6a3-cb8683840bb8
date added to LUP
2026-09-01 16:01:49
date last changed
2026-09-15 16:47:01
@article{36e1854a-c43e-477d-b6a3-cb8683840bb8,
  abstract     = {{<p>Background: Septic arthritis (SA) is considered the most harmful etiology in patients presenting with an acutely painful swollen knee. This study aimed to estimate the incidence, mortality rate, and cause of death among patients diagnosed with SA and compare it to non-infectious causes. Methods: We conducted a population-based observational cohort study in Skåne, southern Sweden, with a population of 1.4 million people. We included adults in the years 2020 and 2021 with cultures obtained at the emergency department from a native knee, where SA was considered a differential diagnosis based on medical chart review. Data on demographics, comorbidities, microbiological etiology, mortality, and treatment were collected. Results: Out of 709 knee joint cultures, 60 (8%) cultures were considered SA. The median age of included patients was 71 years (range 19–97) and 67% were men. The incidence of SA was 2.7 cases per 100,000 person-years. Gout and pyrophosphate arthritis were more prevalent than SA (5.7/100,000 person-years and 6.1/100,000 person-years, respectively. The 90-day all-cause mortality rate for SA was 8% (4/51), compared to mortality rates of 4% (5/126) for gout arthritis and 4% (5/139) for pyrophosphate arthritis, respectively. Possibly one death within 90-days was considered directly associated to SA (2%). No deaths were considered preventable due to inadequate antimicrobial therapy or management. Conclusion: We observed a low incidence of native knee SA, with gout and pyrophosphate arthritis occurring twice as frequently. In our cohort, the infection-related mortality from SA was low and considered non-preventable.</p>}},
  author       = {{Johansson, Amelia and Bornai, Omid and Tverring, Jonas and Ljungquist, Oskar}},
  issn         = {{2398-8835}},
  keywords     = {{acute monoarthritis; incidence; mortality; native knee septic arthritis; preventability}},
  language     = {{eng}},
  number       = {{8}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Health Science Reports}},
  title        = {{Septic Arthritis and Its Mimics : Assessing the Incidence, Mortality Rate, Cause-of Death and Preventability in a Population-Based Cohort Study}},
  url          = {{http://dx.doi.org/10.1002/hsr2.72845}},
  doi          = {{10.1002/hsr2.72845}},
  volume       = {{9}},
  year         = {{2026}},
}