دورية أكاديمية
Severity Adjusted Risk of Long-term Adverse Sequelae Among Children With Osteomyelitis.
| العنوان: | Severity Adjusted Risk of Long-term Adverse Sequelae Among Children With Osteomyelitis. |
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| المؤلفون: | Vorhies JS; From the Department of Orthopaedic Surgery, Stanford Children's Health, Stanford, CA., Lindsay EA; Department of Orthopaedic Surgery, Children's Health System of Texas, Dallas, TX., Tareen NG; Department of Orthopaedic Surgery, Children's Health System of Texas, Dallas, TX., Kellum RJ; Department of Orthopaedic Surgery, Children's Health System of Texas, Dallas, TX., Jo CH; Department of Clinical Orthopaedic Research, Texas Scottish Rite Hospital for Children, Dallas, TX., Copley LA; Departments of Orthopaedic Surgery and Pediatrics, University of Texas Southwestern, Dallas, TX. |
| المصدر: | The Pediatric infectious disease journal [Pediatr Infect Dis J] 2019 Jan; Vol. 38 (1), pp. 26-31. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Williams & Wilkins Country of Publication: United States NLM ID: 8701858 Publication Model: Print Cited Medium: Internet ISSN: 1532-0987 (Electronic) Linking ISSN: 08913668 NLM ISO Abbreviation: Pediatr Infect Dis J Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [Baltimore, Md. : Williams & Wilkins, c1987- |
| مواضيع طبية MeSH: | Patient Outcome Assessment* , Severity of Illness Index*, Osteomyelitis/*complications, Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Prospective Studies ; Regression Analysis ; Risk Factors |
| مستخلص: | Background: The purpose of this investigation was to evaluate the risk for long-term, adverse outcomes among children with osteomyelitis. Methods: Children with osteomyelitis were prospectively enrolled from 2012 to 2014. Care was accomplished by a multidisciplinary team according to an institutional algorithm. Data were collected to define the severity of illness during the initial hospitalization and assess short, intermediate and long-term outcomes. Clinical examination, radiographic assessment and functional outcome survey administration were performed at a minimum of 2 year follow-up. A comparison cohort analysis was performed according to initial severity of illness score of mild (0-2), moderate (3-6) and severe (7-10). Results: Of 195 children enrolled, 139 (71.3%) returned for follow-up at an average of 2.4 years (range, 2.0-5.0 years). Children with severe illness were less likely to have normal radiographs (severe, 4.0%; moderate, 38.2%; mild, 53.2%, P < 0.0001), and more likely to have osteonecrosis, chondrolysis, or deformity (severe, 32.0%; moderate, 5.9%; mild, 1.3%, P < 0.0001). Functional outcome measures did not significantly differ between severity categories. By regression analysis severity of illness score, plus age less than 3 years and Methicillin-resistant Staphylococcus aureus predicted severe sequelae with an area under the curve of 0.8617 and an increasing odds ratio of 1.34 per point of increase in severity score. Conclusion: Long-term severe adverse outcomes among children with osteomyelitis occurred in 11 of 139 (7.9%) children and were predicted by initial severity of illness. Other risks that diminished the likelihood of complete resolution or increased the risk of severe sequelae included Methicillin-resistant Staphylcoccus aureus etiology and young age. The majority of children with osteomyelitis do not require long-term follow-up beyond the initial treatment period. |
| تواريخ الأحداث: | Date Created: 20180510 Date Completed: 20200204 Latest Revision: 20200204 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1097/INF.0000000000002044 |
| PMID: | 29742649 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1532-0987 |
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| DOI: | 10.1097/INF.0000000000002044 |