Clinical outcomes of pediatric osteomyelitis - BMC Pediatrics

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Children with chronic osteomyelitis are more likely to experience pathologic fractures and require multiple surgeries (though serious outcomes are infrequent) than those with acute osteomyelitis, finds a study published in BMCPediatr

, 2015. Pathogens isolated and antimicrobial susceptibility results were identified using the HealthFacts® microbiology and microbiology susceptibility datasets, respectively. Site of pathogen isolation was identified from descriptions in the microbiology dataset.

All complications and sequelae were assessed in the two years following the initial diagnosis. Limb length discrepancies were identified using 22 different ICD-10 diagnosis codes. Long-term orthopedic follow-up was defined as the need for orthopedic follow-up between one and two years following the initial diagnosis. Surgeries related to the osteomyelitis diagnosis were quantified by the assessment of Healthcare Common Procedure Coding System procedures codes.

Descriptive statistics, including means and quartiles, were calculated according to type of osteomyelitis. Differences for categorical variables were determined using the chi-square statistic, and t-tests for mean differences or Wilcoxon rank sum tests/two-sample median test for median differences in distributions by osteomyelitis type and for assessment of age differences. A two-tailed-value of < 0.05 was considered statistically significant.

Acute osteomyelitis was the most common presentation, representing 60.5% of all cases . Chronic co-morbidities were present in 92 subjects , with hematologic and oncologic disorders , pressure ulcers and diabetes most commonly reported.Boys were more commonly affected for both types of osteomyelitis , though this did not reach statistical significance. Children with chronic osteomyelitis were older than those with acute osteomyelitis .

 

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