Use of erythrocyte sedimentation rate and C-reactive protein to predict osteomyelitis recurrence.
To determine the association between both erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and osteomyelitis recurrence.



Records of 81 males and 27 females aged 10 to 87 (median, 54) years who underwent antibiotic/ surgical treatment for primary (n=68) or recurrent (n=40) osteomyelitis that was related (n=26) or unrelated (n=82) to a prosthesis were reviewed. Of the 40 cases of osteomyelitis recurrence followed up for a median of 23.4 (range, 0.6-74.0) months, 7 and 33 were related and unrelated to a prosthesis, respectively. The cutoff points of lowest ESR and CRP for osteomyelitis recurrence were calculated. Risk factors for osteomyelitis recurrence were determined.



Osteomyelitis recurrence was associated with diabetes mellitus, ischaemic heart disease, non-healing wound, infection in the lower limb, and infection with methicillin-resistant Staphylococcus aureus. The cutoff points of CRP ≥5 mg/l and ESR ≥20 mm/h were used for osteomyelitis recurrence. Risk factors for osteomyelitis recurrence were ESR ≥20 mm/h, infection with methicillin-resistant S aureus, and infection in the lower limb.



ESR was more sensitive, specific, and independently associated with osteomyelitis recurrence and should be used to guide the duration of antibiotic treatment.
Department of Emergency Medicine, National University Health System, Singapore.
Z
Z
Lin
Department of Emergency Medicine, National University Health System, Singapore.
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A
Vasudevan
Yong Loo Lin School of Medicine, National University of Singapore, Singapore & Division of Infectious Diseases, University Medicine Cluster, National University Health System, Singapore.
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PA
Tambyah
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D010019:Osteomyelitis / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D011237:Predictive Value of Tests; D012008:Recurrence; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology; D055815:Young Adult
D002097:C-Reactive Protein
C-reactive protein; blood sedimentation; osteomyelitis; recurrence