TABLE 4.
Univariable associations of chronic osteomyelitis, patient characteristics, and management
| Characteristic | Valuesa for patients with: |
P value | |
|---|---|---|---|
| Progression to chronic osteomyelitis (n = 13) | No progression to chronic osteomyelitis (n = 237) | ||
| Age (yrs) | 8.9 (4.2–13.9) | 8.3 (3.1–11.6) | 0.26 |
| Female gender | 4 (30.7) | 96 (40.5) | 0.57 |
| Race | 0.9 | ||
| White | 10 (76.9) | 173 (72.9) | |
| Black | 3 (23.1) | 45 (18.9) | |
| Asian | 0 | 6 (2.5) | |
| Otherb | 0 | 5 (2.1) | |
| Unknown/not disclosed | 0 | 8 (3.4) | |
| Hispanic ethnicity | 2 (15.4) | 69 (29.1) | 0.35 |
| Duration of symptoms on presentation (days) | 5 (4–20) | 5 (3–7) | 1 |
| Multifocal infection | 0 | 11 (4.6) | 1 |
| Subperiosteal/intraosseous abscess | 9 (69.2) | 99 (41.8) | 0.08 |
| Maximum abscess diameterc (cm) | 4.8 (2.9–6.1) | 3 (1.4–4.4) | 0.21 |
| ICU admission | 2 (15.4) | 11 (4.6) | 0.14 |
| Positive blood culture | 11 (84.6) | 133 (56.8) | 0.048 |
| Duration of bacteremia (days) | 1 (1–1) | 1 (1–2) | 0.9 |
| Duration of fever after admission (days) | 1 (0–2) | 2 (0–3) | 0.11 |
| Medical management | |||
| Empiric therapy | 0.18 | ||
| Clindamycin monotherapy | 3 (23.1) | 84 (35.4) | |
| Vancomycin monotherapy | 6 (46.2) | 69 (29.1) | |
| 1GC monotherapy | 1 (7.7) | 9 (3.8) | |
| Vancomycin + nafcillin | 3 (23.1) | 35 (14.8) | |
| Other | 0 | 40 (16.8) | |
| Definitive therapy | 0.26 | ||
| 1GC | 8 (61.5) | 181 (76.4) | |
| Nafcillin | 5 (38.4) | 32 (13.5) | |
| Clindamycin | 0 | 14 (5.9) | |
| Other | 0 | 10 (4.2) | |
| Oral antibiotic at discharge | 5 (38.5) | 120 (50.6) | 0.57 |
| Duration of intravenous antibiotics (days) | 22.5 (10–55) | 14.5 (6–34) | 0.17 |
| Total duration of antibiotics (days) | 46 (32–61) | 42 (31–53) | 0.71 |
| Surgical management | |||
| Surgical procedure performed | 11 (84.6) | 145 (61.2) | 0.14 |
| ≥2 surgical procedures | 7 (53.8) | 38 (15.8) | 0.003 |
| Delayed first source control | 4 (30.7) | 22 (9.2) | 0.03 |
| Duration of follow-up (days) | 61 (32–82) | 79 (36–285) | 0.15 |
a
All continuous variables are presented as medians with interquartile ranges; categorical variables are presented as n (%).
b
Other with regard to race includes Native American/Alaskan Native, Native Hawaiian/Pacific Islander, and self-identified multiple races.
c
Only 61 cases had abscess size documented.