医学
并发症
缺血性坏死
回顾性队列研究
骨髓炎
外科
疾病
队列
慢性复发性多灶性骨髓炎
儿科
内科学
骨炎
股骨头
作者
Sarah Hunter,Joseph F. Baker
出处
期刊:Journal of Pediatric Orthopaedics
[Ovid Technologies (Wolters Kluwer)]
日期:2022-10-17
卷期号:43 (1): e74-e79
被引量:2
标识
DOI:10.1097/bpo.0000000000002275
摘要
Acute hematogenous osteomyelitis (AHO) remains a cause of severe illness among children. Contemporary research aims to identify predictors of acute and chronic complications. Trends in C-reactive protein (CRP) after treatment initiation may predict disease course. We have sought to identify factors associated with acute and chronic complications in the New Zealand population.A retrospective review of all patients younger than16 years with presumed AHO presenting to a tertiary referral centre between 2008 and 2018 was performed. Multivariate was analysis used to identify factors associated with an acute or chronic complication. An "acute" complication was defined as the need for 2 or more surgical procedures, a hospital stays longer than 14 days, or recurrence despite intravenous antibiotics. A "chronic" complication was defined as growth or limb length discrepancy, avascular necrosis, chronic osteomyelitis, pathologic fracture, frozen joint, or dislocation.One hundred fifty-one cases met the inclusion criteria. The median age was 8 years (69.5% male). Within this cohort, 53 (34%) experienced an acute complication and 18 (12%) a chronic complication. Regression analysis showed that contiguous disease, delayed presentation, and failure to reduce CRP by 50% at day 4/5 predicted an acutely complicated disease course. Chronic complication was predicted by the need for surgical management and failed CRP reduction by 50% at day 4/5.CRP trends over 96 hours after the commencement of treatment differentiate patients with AHO likely to experience severe disease.Level II, retrospective study.
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