Pediatric Patients with Osteomyelitis and/or Septic Joint Undergoing Surgical Debridement Have Equivalent Short-Term Outcomes with or without Preoperative MRI
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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No Preop MRI (N = 29) | Preop MRI (N = 75) | Overall (N = 104) | p-Value | |
---|---|---|---|---|
Demographics | ||||
Age (years) | 6.2/7.0 [1.0, 10.0] | 7.6/6.0 [3.0, 12.0] | 7.3/6.0 [3.0, 11.0] | 0.17 I |
Female | 14 (48.3%) | 26 (34.7%) | 40 (38.5%) | 0.20 II |
Presentation | ||||
Symptom Duration (Days) | 6.6/4.0 [2.0, 7.0] | 7.5/5.0 [3.0, 12.0] | 7.3/5.0 [2.5, 7.0] | 0.58 III |
Temperature (°C) | 37.8/37.6 [37.2, 38.3] | 37.5/37.4 [36.9, 38.1] | 37.6/37.5 [36.9, 38.2] | 0.18 I |
ESR (mm/h) | 49.5/44.5 [30.0, 89.5] | 52.3/59.0 [37.0, 75.0] | 51.8/58.0 [32.0, 80.0] | 0.90 I |
CRP (mg/dL) | 10.9/7.6 [3.2, 12.7] | 11.6/9.0 [4.1, 14.4] | 11.5/8.8 [3.5, 14.4] | 0.39 III |
WBC (K/µL) | 16.7/14.0 [10.0, 18.9] | 14.2/13.8 [9.1, 16.7] | 14.8/13.9 [9.2, 17.6] | 0.31 III |
Positive Blood Culture | 8 (27.6%) | 23 (30.7%) | 31 (29.8%) | 0.79 II |
Preoperative Joint Aspiration | 21 (72.4%) | 21 (28.0%) | 42 (40.4%) | <0.0001 II |
Positive Joint Aspiration | 18/21 (85.7%) | 14/21 (67.7%) | 32/42 (76.2%) | 0.15 II |
Timing of OR | ||||
Same Day as Admission | 13 (44.8%) | 15 (20.0%) | 28 (26.9%) | 0.0037 II |
Day after Admission | 14 (48.3%) | 33 (44.0%) | 47 (45.2%) | - |
2 or More Days after MRI | 2 (6.9%) | 27 (36.0% | 29 (27.9%) | - |
Final Diagnosis | ||||
Osteomyelitis | 4 (13.8%) | 43 (57.3%) | 47 (45.2%) | <0.0001 II |
Septic Joint | 19 (65.5%) | 15 (20.0%) | 34 (32.7%) | - |
Septic Joint + Osteomyelitis | 6 (20.7%) | 17 (22.7%) | 23 (22.1%) | - |
No Preop MRI (N = 29) | Preop MRI (N = 75) | Overall (N = 104) | p-Value | |
---|---|---|---|---|
Outcomes | ||||
Time from OR to Discharge (Days) | 5.8/5.0 [4.0, 8.0] | 5.4/4.0 [3.0, 7.0] | 5.5/5.0 [3.0, 7.0] | 0.57 II |
Total Number of Debridements | ||||
1 | 21 (72.4%) | 56 (74.7%) | 77 (74.0%) | 0.23 III |
2 | 7 (24.1%) | 10 (13.3%) | 17 (16.3%) | - |
3+ | 1 (3.4%) | 9 (12.0%) | 10 (9.6%) | - |
Total Admissions | ||||
1 | 26 (89.7%) | 60 (80.0%) | 86 (82.7%) | 0.24 I |
2+ | 3 (10.3%) | 15 (20.0%) | 18 (17.3%) | - |
Total MRIs | ||||
1 | 23 (79.3%) | 51 (68.0%) | 74 (71.2%) | 0.23 III |
2 | 5 (17.2%) | 12 (16.0%) | 17 (16.3%) | - |
3+ | 1 (3.4%) | 12 (16.0%) | 13 (12.5%) | - |
No Preop MRI (N = 25) | Preop MRI (N = 32) | Overall (N = 57) | p-Value | |
---|---|---|---|---|
Demographics | ||||
Age (years) | 6.4/6.0 [3.0, 10.0] | 5.8/3.5 [2.0, 11.0] | 6.1/5.0 [2.0, 11.0] | 0.72 II |
Female | 11 (44%) | 11 (34.4%) | 22 (38.6%) | 0.46 I |
Presentation | ||||
Symptom Duration (Days) | 5.0/6.4 [2.0, 7.0] | 6.8/4.5 [2.5, 7.0] | 6.1/5.0 [2.0, 7.0] | 0.71 II |
Temperature (°C) | 37.8/37.6 [37.4, 38.3] | 37.6/37.5 [37.2, 38.0] | 37.7/37.6 [37.2, 38.1] | 0.27 II |
ESR (mm/h) | 50.0/60.5 [31.0, 91.0] | 58.3/58.0 [31.0, 80.0] | 55.8/58.0 [31.0, 90.0] | 0.57 II |
CRP (mg/dL) | 12.5/8.3 [4.0, 16.7] | 9.4/8.8 [4.7, 10.6] | 10.3/8.7 [4.1, 12.4] | 0.85 II |
WBC (K/µL) | 15.5/12.8 [10.0, 18.0] | 14.3/14.4 [10.3, 15.9] | 14.8/14.0 [10.0, 17.0] | 0.58 II |
Positive Blood Culture | 7 (28.0%) | 9 (28.1%) | 16 (28.1%) | 0.77 III |
Preoperative Joint Aspiration | 20 (80.0%) | 15 (46.9%) | 35 (61.4%) | 0.01 I |
Positive Joint Aspiration | 18/20 (92.0%) | 11/15 (73.3%) | 29/35 (50.9%) | 0.20 I |
Timing of OR | ||||
Same Day as Admission | 12 (48.0%) | 7 (21.9%) | 19 (33.3%) | 0.023 I |
Day after Admission | 12 (48.0%) | 16 (50.0%) | 28 (49.1%) | - |
2 or More Days after MRI | 1 (4.0%) | 9 (28.1)% | 10 (17.5%) | - |
No Preop MRI (N = 25) | Preop MRI (N = 32) | Overall (N = 57) | p-Value | |
---|---|---|---|---|
Outcomes | ||||
Time from OR to Discharge (Days) | 6.7/5.0 [4.0, 8.0] | 6.2/5.0 [4.0, 7.5] | 6.4/5.0 [4.0, 8.0] | 0.77 I |
Total Number of Debridements | ||||
1 | 17 (68.0%) | 27 (84.4%) | 44 (77.2%) | 0.17 II |
2 | 7 (28.0%) | 3 (9.4%) | 10 (17.5%) | - |
3+ | 1 (4.0%) | 2 (6.3%) | 3 (5.3%) | - |
Total Admissions | ||||
1 | 22 (88.0%) | 27 (84.4%) | 49 (86.0%) | 1 II |
2+ | 3 (12.0%) | 5 (15.6%) | 8 (14.0%) | - |
Total MRIs | ||||
1 | 20 (80.0%) | 22 (68.8%) | 42 (73.7%) | 0.46 II |
2 | 4 (16.0%) | 5 (15.6%) | 9 (15.8%) | - |
3+ | 1 (4.0%) | 5 (15.6%) | 6 (10.5%) | - |
Joint | Preop MRI | No Preop MRI | Total | p-Value |
---|---|---|---|---|
Hip | 13 | 9 | 22 | |
Concurrent OM | 8 | 2 | 10 | 0.068 I |
OM Debridement | 3 | 0 | 3 | 0.121 I |
Knee | 8 | 8 | 16 | |
Concurrent OM | 4 | 4 | 4 | 1.000 I |
OM Debridement | 0 | 0 | 0 | 1.000 I |
Shoulder | 5 | 3 | 8 | |
Concurrent OM | 3 | 1 | 4 | 0.465 I |
OM Debridement | 1 | 0 | 1 | 0.408 I |
Elbow | 3 | 2 | 5 | |
Concurrent OM | 1 | 1 | 2 | 0.709 I |
OM Debridement | 1 | 1 | 2 | 0.709 I |
Ankle | 3 | 1 | 4 | |
Concurrent OM | 3 | 0 | 3 | 0.046 I |
OM Debridement | 3 | 0 | 3 | 0.046 I |
Wrist | 0 | 2 | 2 | |
Concurrent OM | 0 | 0 | 0 | 1.000 I |
OM Debridement | 0 | 0 | 0 | 1.000 I |
Total | 32 | 25 | 57 | |
Concurrent OM | 17 | 6 | 23 | 0.026 I |
OM Debridement | 8 | 1 | 9 | 0.031 I |
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Englert, E.G.; Braithwaite, C.L.; Aguirre-Flores, M.E.; Lam, A.W.; Sarraj, M.; Kumagai, A.; Bednar, E.D.; Gordon, A.M.; Salama, I.; Keeley, J.; et al. Pediatric Patients with Osteomyelitis and/or Septic Joint Undergoing Surgical Debridement Have Equivalent Short-Term Outcomes with or without Preoperative MRI. Children 2024, 11, 300. https://doi.org/10.3390/children11030300
Englert EG, Braithwaite CL, Aguirre-Flores ME, Lam AW, Sarraj M, Kumagai A, Bednar ED, Gordon AM, Salama I, Keeley J, et al. Pediatric Patients with Osteomyelitis and/or Septic Joint Undergoing Surgical Debridement Have Equivalent Short-Term Outcomes with or without Preoperative MRI. Children. 2024; 11(3):300. https://doi.org/10.3390/children11030300
Chicago/Turabian StyleEnglert, E. Graham, Collin L. Braithwaite, Maria E. Aguirre-Flores, Aaron W. Lam, Mohamed Sarraj, Abigail Kumagai, E. Dimitra Bednar, Adam M. Gordon, Ibrahim Salama, Jacob Keeley, and et al. 2024. "Pediatric Patients with Osteomyelitis and/or Septic Joint Undergoing Surgical Debridement Have Equivalent Short-Term Outcomes with or without Preoperative MRI" Children 11, no. 3: 300. https://doi.org/10.3390/children11030300
APA StyleEnglert, E. G., Braithwaite, C. L., Aguirre-Flores, M. E., Lam, A. W., Sarraj, M., Kumagai, A., Bednar, E. D., Gordon, A. M., Salama, I., Keeley, J., Pathak, I., Kishta, W., Thabet, A. M., Abdelgawad, A., & Saleh, E. (2024). Pediatric Patients with Osteomyelitis and/or Septic Joint Undergoing Surgical Debridement Have Equivalent Short-Term Outcomes with or without Preoperative MRI. Children, 11(3), 300. https://doi.org/10.3390/children11030300