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Predictive model for surgical intervention in pediatric acute hematogenous osteomyelitis
Jiale Guo1,2, Wei Feng1,2, Baojian Song1,2
1Department of Orthopaedic, Beijing Children's Hospital, Capital Medical University, Nanlishi Road 56, Xicheng District, Beijing, 100045, China.
This study identifies key predictors for surgical intervention in acute hematogenous osteomyelitis (AHO). Elevated neutrophil counts and MRSA presence indicate higher surgical risk, aiding in better patient management.
Area of Science:
- Pediatric Orthopedics
- Infectious Diseases
- Medical Informatics
Background:
- Multidrug-resistant bacteria complicate acute hematogenous osteomyelitis (AHO) treatment.
- Increased surgical intervention necessity due to worsening prognoses.
- Need for predictive models for surgical risk in AHO patients.
Purpose of the Study:
- Identify risk factors for surgical intervention in pediatric AHO.
- Develop and validate prediction models for surgical outcomes.
- Improve clinical decision-making for AHO management.
Main Methods:
- Retrospective chart review of 218 pediatric AHO patients (2015-2022).
- Multivariate logistic regression to identify risk factors for single/multiple surgeries.
- Nomogram and ROC curve analysis for model validation.
Main Results:
- Absolute neutrophil count (ANC) and Methicillin-resistant Staphylococcus aureus (MRSA) predicted surgical intervention (AUC=0.76).
- C-reactive protein (CRP) levels predicted multiple surgeries (AUC=0.91).
- Developed models showed good fit and discriminative ability.
Conclusions:
- Two validated prediction models for AHO surgical risk were developed.
- Models demonstrate promising accuracy and discrimination for clinical application.
- Predictive tools can aid in optimizing AHO patient care.
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