Evidence map›Paper›PMID 40189216›Full record

ArticleHospital pediatrics2025

Intravenous Dexamethasone Use and Outcomes in Children Hospitalized With Septic Arthritis.

Andrew S Kern-Goldberger, Matthew Hall, Marcos Mestre, Jessica L Markham, Marie E Wang, Pratichi K Goenka, Laura H Brower, Alison Payson, Mary Villani, Jaime Rice Denning and 1 more

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Article in Hospital pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Andrew S Kern-GoldbergerDivision of Pediatric Hospital Medicine, Cleveland Clinic Children's Hospital and Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio.
Matthew HallChildren's Hospital Association, Lenexa, Kansas.
Marcos MestreDepartment of Pediatrics, Nicklaus Children's Hospital, Miami, Florida.
Jessica L MarkhamDepartment of Pediatrics, Children's Mercy Kansas City and University of Missouri Kansas City, Kansas City, Missouri.
Marie E WangDepartment of Pediatrics, Stanford University School of Medicine and Lucile Packard Children's Hospital Stanford, California.
Pratichi K GoenkaDepartment of Pediatrics, Cohen Children's Medical Center-Northwell Health and Zucker School of Medicine at Hofstra/Northwell, Hofstra University, New Hyde Park, New York.
Laura H BrowerDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio.
Alison PaysonDepartment of Pediatrics, Cohen Children's Medical Center-Northwell Health and Zucker School of Medicine at Hofstra/Northwell, Hofstra University, New Hyde Park, New York.
Mary VillaniDepartment of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas.
Jaime Rice DenningDivision of Orthopedics, Cincinnati Children's Hospital Medical Center and the University of Cincinnati Department of Orthopedic Surgery, Cincinnati, Ohio.
Samir S ShahDepartment of Pediatrics, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, Ohio.

Funding

AHRQ HHS K08 HS028845
6 · The paper itself

Abstract

backgroundSeptic arthritis is routinely treated with joint drainage and antibiotics; however, adjunctive systemic corticosteroids may improve outcomes.

objectivesTo (1) describe variation in intravenous dexamethasone use and (2) evaluate the association of intravenous dexamethasone use with outcomes among children hospitalized with septic arthritis.

methodsThis is a retrospective cohort study of hospitalized children using the Pediatric Health Information System database. We identified intravenous dexamethasone use (on hospital days 0-2) in children with an International Classification of Diseases, Tenth Revision discharge code for septic arthritis (M00.x). The primary outcome was hospital length of stay (LOS). Secondary outcomes included costs, postdrainage imaging, opioid use, repeat drainage procedures, and 30-day emergency department or hospital revisits. We used propensity score matching to account for measured differences between dexamethasone recipients and nonrecipients.

resultsWe identified 3524 hospitalizations across 47 hospitals from 2016 to 2020. The median rate of dexamethasone use across hospitals was 28% (IQR, 19%-44%). In the propensity-matched cohort, dexamethasone was associated with shorter LOS (100.5 vs 114.3 hours, P < .001) and lower costs ($16 660 vs $18 243, P = .01) but greater opioid use (odds ratio [OR], 3.80; 95% CI, 1.49-9.70; P < .01). There were no significant differences in 30-day revisits (OR, 0.97; 95% CI, 0.73-1.29; P = .84), postdrainage computed tomography or magnetic resonance imaging (OR, 0.91; 95% CI, 0.71-1.15; P = .42), or repeat drainage procedures (OR, 1.01; 95% CI, 0.81-1.25; P = .94).

conclusionIn this large cohort study, children with septic arthritis receiving dexamethasone had shorter hospital LOS and costs without higher 30-day revisit rates. Dexamethasone use varied widely across hospitals. These findings highlight the need for evaluation in a multicenter randomized trial.

Indexed as

Arthritis, InfectiousDexamethasoneGlucocorticoidsAdministration, IntravenousAdolescentChildChild, PreschoolFemaleHospitalizationHumansInfantLength of StayMalePropensity ScoreRetrospective StudiesTreatment OutcomeDexamethasoneGlucocorticoids

Identifiers

PMID40189216
PMCPMC12210227

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