Table 1 Demographic, clinical, microbiological and therapeutic features of the patients according to the outcome
From: Factors predictive of relapse in adult bacterial osteomyelitis of long bones.
Relapse (n = 26) | No relapse (n = 90) | P | ||
|---|---|---|---|---|
Gender | Male | 16 (18.6%) | 70 (81.4%) | 0.096 |
Female | 10 (33.3%) | 20 (66.7%) | ||
Age | Years | 57.42 (51.13–63.72) | 51.67 (47.93–55.40) | 0.14 |
Origin/source | Hematogenous | 4 (20.0%) | 16 (80.0%) | 0.5 |
Post-traumatic | 12 (19.4%) | 50 (80.6%) | ||
Post-surgical | 10 (29.4%) | 24 (70.6%) | ||
Bones involved | Femur | 6 (22.2%) | 21 (77.8%) | 0.9 |
Tibia | 17 (23.6%) | 55 (76.4%) | ||
Fibula | 1 (16.7%) | 5 (83.3%) | ||
Humerus | 0 (0%) | 3 (100%) | ||
Ulna | 1 (20.0%) | 4 (80.0%) | ||
Radius | 1 (33.3%) | 2 (66.7%) | ||
Imaging (other than radiographs) | Yes | 20 (28.2%) | 51 (71.8%) | 0.06 |
No | 6 (13.3%) | 39 (86.7%) | ||
C Reactive Protein (C-RP) | mg/L | 8.865 (.357–17.373) | 6.440 (4.739–8.1395) | 0.6 |
Erythrocyte sedimentation rate (ESR) | mm/h | 53.52 (37.26–69.78) | 65.01 (57.20–72.82) | 0.18 |
Duration of follow-up | Months | 56.12 (37.80–74.43) | 70.28 (58.67–81.89) | 0.24 |
Severity factors | ||||
Relapse of previous osteomyelitis | Yes | 14 (28.6%) | 35 (71.4%) | 0.17 |
No | 12 (17.9%) | 55 (82.1%) | ||
Symptoms longer than 3 months | Yes | 22 (28.6%) | 55 (71.4%) | 0.025 |
No | 4 (10.3%) | 35 (89.7%) | ||
Presence of osteosynthesis material | Yes | 13 (22.0%) | 46 (78.0%) | 0.9 |
No | 13 (22.8%) | 44 (77.2%) | ||
Bone exposure | Yes | 12 (26.1%) | 34 (73.9%) | 0.4 |
No | 14 (20.0%) | 56 (80.0%) | ||
Vascular involvement | Yes | 5 (45.5%) | 6 (54.5%) | 0.067 |
No | 21 (20.0%) | 84 (80.0%) | ||
Diabetes | Yes | 3 (30.0%) | 7 (70.0%) | 0.7 |
No | 23 (21.7%) | 83 (78.3%) | ||
Multiresistant/polymicrobial infection | Yes | 12 (23.5%) | 39 (76.5%) | 0.8 |
No | 14 (21.5%) | 51 (78.5%) | ||
Immunosuppression | Yes | 2 (50.0%) | 2 (50.0%) | 0.22 |
No | 24 (21.4%) | 88 (78.6%) | ||
Presence of severity factors | Yes | 12 (29.3%) | 29 (70.7%) | 0.19 |
No | 14 (18.7%) | 61 (81.3%) | ||
Types of severity factors | No | 14 (18.7%) | 61 (81.3%) | 0.4 |
Local | 5 (22.7%) | 17 (77.3%) | ||
Systemic | 4 (40.0%) | 6 (60.0%) | ||
Both | 3 (33.3%) | 6 (66.7%) | ||
Number of severity factors | 3.19 (2.69–3.69) | 2.49 (2.2–2.76) | 0.02 | |
Microbiology | ||||
Gram-positive cocci a | Gram-positive cocci | 17 (24.6%) | 52 (75.4%) | 0.8 |
Others | 6 (27.3%) | 16 (72.7%) | ||
Gram-negative bacilli a | Gram-negative bacilli | 9 (28.1%) | 23 (71.9%) | 0.8 |
Others | 15 (25.4%) | 44 (74.6%) | ||
Staphylococcus aureus a | S aureus | 12 (25.0%) | 36 (75.0%) | 0.9 |
Others | 8 (23.5%) | 26 (76.5%) | ||
Gram-pos cocci vs Gram-neg bacilli a | Gram-positive cocci | 14 (25.0%) | 42 (75.0%) | 0.8 |
Gram-negative bacilli | 6 (27.3%) | 16 (72.7%) | ||
Treatment | ||||
Type of treatment | Antibiotics only | 6 (66.7%) | 3 (33.3%) | 0.004 |
Antibiotics plus surgery | 20 (18.7%) | 87 (81.3%) | ||
Intravenous beta-lactams | β-lactams | 5 (13.9%) | 31 (86.1%) | 0.7 |
Other antibiotics | 4 (18.2%) | 18 (81.8%) | ||
Oral β-lactams | β-lactams | 4 (23.5%) | 13 (76.5%) | 0.7 |
Other antibiotics | 9 (17.3%) | 43 (82.7%) | ||
Oral clindamycin | Clindamycin | 3 (10.7%) | 25 (89.3%) | 0.21 |
Other antibiotics | 11 (22.0%) | 39 (78.0%) | ||
Oral rifampin | Rifampin | 4 (15.4%) | 22 (84.6%) | 0.8 |
Other antibiotics | 10 (19.2%) | 42 (80.8%) | ||
Duration of intravenous antibiotics | Days | 26.44 (23.24–29.64) | 29.33 (27.09–31.58) | 0.21 |
Total duration of antibiotic treatment | Days | 80.76 (36.05–125.47) | 69.58 (62.66–76.49) | 0.40 |
Type of surgery | None | 6 (66.7%) | 3 (33.3%) | 0.004 |
Debridement | 9 (19.6%) | 37 (80.4%) | ||
Debridement and flap | 11 (18.0%) | 50 (82.0%) | ||
Removal of osteosynthesis material b | Yes | 8 (19.0%) | 34 (81.0%) | 0.24 |
No | 4 (36.4%) | 7 (63.6%) | ||
Type of surgical reconstruction | None | 15 (27.3%) | 40 (72.7%) | 0.6 |
Free muscle flap | 2 (14.3%) | 12 (85.7%) | ||
Pedicled muscle flap | 4 (19.0%) | 17 (81.0%) | ||
Free fasciocutaneous flap | 5 (23.8%) | 16 (76.2%) | ||
Pedicled fasciocutaneous flap/rotation | 0 (0%) | 5 (100%) | ||
Surgical reconstruction | Yes (all types of flaps) | 11 (18.0%) | 50 (82.0%) | 0.23 |
No | 15 (27.3%) | 40 (72.7%) | ||