Wash, Rinse, Repeat: Which Patients Undergo Serial Joint Irrigation in Pediatric Septic Hip Arthritis?
| Autor: | Kristin S. Livingston, Benjamin J. Shore, Young-Jo Kim, Donald S. Bae, Leslie A. Kalish |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Adolescent Arthritis Single Center 03 medical and health sciences 0302 clinical medicine Risk Factors Interquartile range Synovial Fluid Left shift medicine Humans Orthopedics and Sports Medicine Diagnostic Errors Risk factor Child Therapeutic Irrigation Retrospective Studies Arthritis Infectious 030222 orthopedics Framingham Risk Score business.industry Washout General Medicine medicine.disease Magnetic Resonance Imaging Outcome and Process Assessment Health Care Case-Control Studies Child Preschool Anesthesia Pediatrics Perinatology and Child Health Female Hip Joint Septic arthritis business |
| Zdroj: | Journal of Pediatric Orthopaedics. 39:e494-e499 |
| ISSN: | 0271-6798 |
| DOI: | 10.1097/bpo.0000000000001323 |
| Popis: | BACKGROUND The purpose of this study is to identify risk factors associated with repeat surgical irrigation in pediatric septic hip arthritis. METHODS A single center retrospective case-control study was performed. Patients who underwent ≥2 washouts (cases) were compared with those who had only 1 washout (controls). Demographic, clinical, laboratory, microbial, and magnetic resonance imaging data were compared between cases and controls and a prediction model was developed using logistic regression. A risk score was then constructed by counting the number of risk factors from the model that were present in each patient. RESULTS We identified 26 patients between 1994 and 2015 who underwent ≥2 washouts for septic hip arthritis, and 63 control patients who had only a single washout. Twenty-two patients had 2 washouts, 3 had 4 washouts, 1 had 5 washouts. Median number of days between first and second washout was 5 (interquartile range, 4 to 8). The most common reason for repeat washout was persistent fever (N=21), followed by persistently elevated laboratory values (N=13), abnormal magnetic resonance imaging findings (N=12), and continued pain (N=12). Repeat washout cases demonstrated higher temperature preoperatively (P |
| Databáze: | OpenAIRE |
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