Factors Associated with Delayed Diagnosis of Septic Arthritis in Patients Treated at Aranyaprathet Hospital

Abstract

Septic arthritis is an orthopedic emergency that may result in joint destruction, complications, and prolonged hospitalization if diagnosis is delayed. This study aimed to investigate factors associated with delayed diagnosis and to compare the clinical outcomes of patients with septic arthritis treated at Aranyaprathet Hospital, Sa Kaeo Province. This retrospective analytic study included 77 patients diagnosed with septic arthritis and treated at Aranyaprathet Hospital between January 1, 2017, and September 30, 2025. Data were collected from medical records and the hospital information system using standardized case record forms. Data were analyzed using descriptive and inferential statistics, including the chi-square test, Fisher’s exact test, independent t-test, and multivariable logistic regression analysis.

The results showed that delayed diagnosis, defined as more than 48 hours from symptom onset, occurred in 51.9% of patients. Factors associated with delayed diagnosis included referral from the community hospital network (aOR 3.10, 95% CI 1.34–7.18), pre-existing osteoarthritis (aOR 2.74, 95% CI 1.21–6.12), and age ≥65 years (aOR 1.92, 95% CI 1.03–3.57). Patients in the delayed diagnosis group had a significantly longer hospital stay compared with those diagnosed earlier (16.1 ± 5.2 days vs. 12.3 ± 4.3 days, p = 0.01). However, there were no significant differences in surgical intervention rates or complication rates between the two groups. In conclusion, elderly patients with pre-existing osteoarthritis and those referred from network community hospitals were more likely to experience delayed diagnosis of septic arthritis. Delayed diagnosis was associated with prolonged hospitalization. Therefore, improved screening and referral systems for high-risk patients should be developed.