ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Prediction of Adverse Outcomes in Pediatric Acute Hematogenous Osteomyelitis.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 56 citations in OpenAlex.
- Multifocal osteomyelitis and abscess due to Bacteroides caccae in a child with sickle cell disease.BMC pediatrics · 2026Article
- Developing a nomogram based on admission AGR and CLR to predict subsequent surgical intervention in pediatric acute hematogenous osteomyelitis.Scientific reports · 2026Article
- Exploring and validating the molecular targets and potential mechanisms of shikonin against osteomyelitis through computational analyses and animal experiments.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Admission albumin and C-reactive protein-to-lymphocyte ratio are associated with MRI-defined abscess in children with acute hematogenous osteomyelitis: a two-center retrospective study.Frontiers in cellular and infection microbiology · 2026Observational
- Case Report: Distal tibial physeal injury secondary to conservative treatment of acute hematogenous osteomyelitis resulting in ankle deformity - highlighting the necessity of regular follow-up.Frontiers in surgery · 2026Article
- Pathogen virulence and host response: A systematic review of severe illness in childhood musculoskeletal infection.Journal of clinical orthopaedics and trauma · 2026Review
- Clinical features and sequelae of pediatric osteomyelitis following surgical treatment: a 10-year retrospective study.BMC infectious diseases · 2025Article
- Clinical characteristics and risk factors for poor prognosis in children with complicated acute hematogenous osteomyelitis treated with vaccum sealing drainage.BMC musculoskeletal disorders · 2025Article
- Management of pathologic fracture of long bones as a complication of acute osteomyelitis: a challenging task for orthopedic surgeons.BMC musculoskeletal disorders · 2025Article
- Analysis of clinical characteristics and risk factors for Staphylococcus aureus disseminated infection secondary to acute osteoarticular infections in children.Italian journal of pediatrics · 2025Article
- Predicting the presence of adjacent septic arthritis in children with acute hematogenous osteomyelitis.BMC musculoskeletal disorders · 2025Article
- Case Report: Osteomyelitis in a giant panda (Frontiers in veterinary science · 2025Article
- Developing a nomogram for predicting acute complicated course in pediatric acute hematogenous osteomyelitis.Italian journal of pediatrics · 2024Article
- Predictors of Developing a Complex Course of Osteomyelitis in Patients with Sickle Cell Anaemia.Sultan Qaboos University medical journal · 2024Article
- Acute hematogenous osteomyelitis in children: Management of pandiaphysitis with extensive bone destruction: A case series of thirteen child.Annals of medicine and surgery (2012) · 2022Article
- DistinguishingMicroorganisms · 2022Article
- Management and Prevention of Staphylococcus aureus Infections in Children.Infectious disease clinics of North America · 2022Review
- Surveillance of osteoarticular infections caused byFrontiers in cellular and infection microbiology · 2022Article
- Delaying antimicrobials for pediatric bone and joint infections: Balancing clinical risks with diagnostic benefits.Frontiers in pediatrics · 2022Article
- Clinical Epidemiology and Outcomes of Pediatric Musculoskeletal Infections.The Journal of pediatrics · 2021Article
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundClinicians cannot reliably predict complications of acute hematogenous osteomyelitis (AHO).
methodsConsecutive cases of AHO from 2 pediatric centers in the United States were analyzed retrospectively to develop clinical tools from data obtained within 96 hours of hospitalization to predict acute and chronic complications of AHO. Two novel composite prediction scores derived from multivariable logistic regression modeling were compared with a previously published severity of illness (SOI) score, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) using area under the receiver operating characteristic curve analyses.
resultsThe causative organisms were identified in 73% of 261 cases. Bacteremia (45%), abscesses (38%), and associated suppurative arthritis (23%) were relatively common. Acute or chronic complications occurred in 24% and 11% of patients, respectively. Multivariable logistic regression identified bone abscess (odds ratio [OR], 2.3 [95% confidence interval {CI}, 1.0-5.2]), fever > 48 hours (OR, 2.7 [95% CI, 1.2-6.0]), suppurative arthritis (OR, 3.2 [95% CI, 1.3-7.5]), disseminated disease (OR, 4.6 [95% CI, 1.5-14.3]), and delayed source control (OR, 5.1 [95% CI, 1.4-19.0]) as strong predictors of acute complications. In a separate model, CRP ≥ 100 mg/L at 2-4 days after antibiotics (OR, 2.7 [95% CI, 1.0-7.3]), disseminated disease (OR, 3.3 [95% CI, 1.1-10.0]), and requirement for bone debridement (OR, 6.7 [95% CI, 2.1-21.0]) strongly predicted chronic morbidity. These variables were combined to create weighted composite prediction scores for acute (A-SCORE) and chronic (C-SCORE) osteomyelitis, which were superior to SOI, CRP, and ESR and had negative predictive values > 90%.
conclusionsTwo novel composite clinical scores were superior to existing tools to predict complications of pediatric AHO.
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