Table 3.
Associations of Orthopedic Complications and Treatment Variables
| Clinical Characteristics | All Patients (n = 286) |
Patients With Orthopedic Complications (n = 27) |
Patients Without Orthopedic Complications (n = 259) |
P Value |
|---|---|---|---|---|
| Empiric therapy | ||||
| Clindamycin monotherapy | 105 (36.7) | 6 (22.2) | 99 (38.2) | .14 |
| Vancomycin monotherapy | 108 (37.8) | 10 (37) | 98 (37.8) | 1 |
| Vancomycin + Nafcillin | 50 (17.5) | 8 (29.6) | 42 (16.2) | .11 |
| Ineffective empiric therapya | 12 (4.2) | 2 (7.4) | 10 (3.9) | .31 |
| Time from admission to initiation of effective antibiotics, daysb | 1 (0–1) | 1 (0–1) | 1 (0–1) | .49 |
| Definitive therapy | ||||
| First-generation cephalosporin | 165 (57.7) | 17 (62.9) | 148 (57.1) | .68 |
| Clindamycin | 67 (23.4) | 4 (14.8) | 63 (24.3) | .31 |
| Vancomycin | 23 (8) | 3 (11.1) | 20 (7.7) | .47 |
| Oral antibiotics at discharge | 125 (43.7) | 8 (29.6) | 117 (45.1) | .15 |
| Duration of total antibiotic therapy, daysc | 42 (29–55) | 42 (33–64) | 41 (29–55) | .36 |
| Surgical procedure performed | 206 (72.1) | 23 (85.1) | 183 (70.7) | .12 |
| Corticotomy and/or incision/drainage of subperiosteal abscessd | 154 (53.8) | 19 (70.4) | 135 (52.1) | .11 |
| Bone biopsyd | 53 (18.5) | 7 (25.9) | 46 (17.8) | .3 |
| Arthrocentesis and/or arthrotomyd | 127 (44.4) | 14 (51.9) | 113 (43.6) | .42 |
| Drainage/debridement of adjacent soft tissued | 40 (13.9) | 6 (22.2) | 34 (13.1) | .24 |
| External drain placedd | 160 (55.9) | 19 (70.4) | 141 (54.4) | .15 |
| More than 1 surgical procedure | 37 (12.9) | 13 (48.1) | 24 (9.3) | <.001 |
| Time from admission to first surgical procedure, days | 1 (0–2) | 1.5 (1–2) | 1 (0–2) | .22 |
| Delayed source control | 28 (9.8) | 7 (25.9) | 21 (6.5) | <.001 |
| Duration of total follow-up, dayse | 85.5 (34.5–280.5) | 67.5 (46–100) | 95 (34–337) | .37 |
aAll cases of ineffective empiric therapy were the result of clindamycin being prescribed empirically in patients who were ultimately found to be infected with a clindamycin-resistant S. aureus.
bAll continuous variables expressed as medians with interquartile ranges.
cFor each patient who developed a complication and had therapy extended because of the complication, duration of therapy was regarded as the time the patient received antibiotics until diagnosis with an orthopedic complication.
dNot mutually exclusive categories.
eFor patients who developed complications, the date of diagnosis with complications was regarded as the date of follow-up; details on follow-up outcomes of patients who developed complications are provided in the Supplementary Materials.