title: Predictors of Outcome in Pediatric Osteomyelitis: Five Years Experience in a Single Tertiary Center.
abstract: BACKGROUND
  Acute haematogenous osteomyelitis is a bacterial infection of bone, which occurs most frequently in children. Outcomes are excellent for the majority of children, but a minority develop complicated osteomyelitis. Predicting which children will develop complicated osteomyelitis remains a challenge, particularly in developed countries where most patients are discharged home after a relatively short period in hospital.
  
  
  METHODS
  We conducted a 5-year retrospective case note review of all children aged 3 months to 16 years admitted with a diagnosis of acute haematogenous osteomyelitis. We compared standardized clinical and laboratory parameters in those who developed simple and complicated osteomyelitis.
  
  
  RESULTS
  Of the 299 children who met inclusion, 241 (80.6%) had simple and 58 (19.4%) had complicated osteomyelitis. The major predictors of complicated disease were older age, a temperature greater than 38.5°C and a higher C-reactive protein at admission.
  
  
  CONCLUSIONS
  A risk prediction model, utilizing information available shortly after hospitalization, allows early identification of children at greatest risk of developing complicated osteomyelitis.
authors.affiliation: From the *Department of General Paediatrics, Princess Margaret Hospital for Children, Perth, Australia; †School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia, ‡Telethon Kids Institute, Perth, Australia; §Department of Orthopaedic Surgery, Princess Margaret Hospital for Children, Perth, Australia; ¶Murdoch Childrens Research Institute, Parkville, Australia; ‖Department of Paediatrics, University of Melbourne, Parkville, Australia; **Department of Paediatrics, Monash University, Clayton, Australia; ††PathWest Laboratory Medicine WA, Princess Margaret Hospital for Children, Perth, Australia; and ‡‡Department of Infectious Diseases, Princess Margaret Hospital for Children, Perth, Australia.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Martin
authors.forename: Denise
authors.initials: D
authors.lastname: Anderson
authors.forename: Julie
authors.initials: J
authors.lastname: Lucey
authors.forename: Robin
authors.initials: R
authors.lastname: Guttinger
authors.forename: Peter A
authors.initials: PA
authors.lastname: Jacoby
authors.forename: Tabitha J
authors.initials: TJ
authors.lastname: Mok
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Whitmore
authors.forename: Colin N
authors.initials: CN
authors.lastname: Whitewood
authors.forename: David P
authors.initials: DP
authors.lastname: Burgner
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Blyth
mesh_terms: D000293:Adolescent; D015415:Biomarkers; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D064847:Multimodal Imaging; D016017:Odds Ratio; D010019:Osteomyelitis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D063868:Patient Outcome Assessment; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D062606:Tertiary Care Centers
chemical_list: D015415:Biomarkers