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Osteoarticular Infections: Younger Children With Septic Arthritis and Low Inflammatory Patterns Have a Better

Catarina Gouveia1,2, Ana Subtil3,4, Pedro Aguiar3

  • 1Faculdade de Ciências Médicas, Nova Medical School.

The Pediatric Infectious Disease Journal
|August 25, 2023
PubMed

Insights

Predicting complications and sequelae in pediatric osteoarticular infections (OAI) is crucial. This study developed risk models identifying children at low risk for adverse outcomes, potentially guiding less aggressive treatment strategies.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Epidemiology
  • Biostatistics

Background:

  • Osteoarticular infections (OAI) in children can lead to significant complications and long-term sequelae.
  • Early prediction of these adverse outcomes is vital for improving patient management and prognosis.

Purpose of the Study:

  • To develop and validate risk prediction models for identifying children with OAI at risk of acute complicated course (ACC) and long-term sequelae.
  • To aid in early identification of high-risk pediatric patients with OAI.

Main Methods:

  • An observational study included 240 children (aged >3 months to 17 years) with acute OAI admitted between 2008 and 2018.
  • Multivariable logistic regression models were developed to predict ACC and sequelae at 6 and 12 months.
  • Key predictors were identified using clinical data, laboratory values, and infection characteristics.

Main Results:

  • 17.5% of children experienced an ACC, while 6.0% and 3.6% had sequelae at 6 and 12 months, respectively.
  • Predictors for ACC included fever, elevated C-reactive protein, osteomyelitis, and Staphylococcus aureus infection (AUC=0.831).
  • Predictors for 6-month sequelae included older age, elevated C-reactive protein, disseminated disease, and bone abscess (AUC=0.887).

Conclusions:

  • The developed models effectively identify children with OAI at low risk for complications and sequelae.
  • These findings may support a less aggressive management approach for identified low-risk patients.
Abstract

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