Evaluation and Treatment of Pediatric Musculoskeletal Infection at Children's Medical Center According to Evidence Based Guidelines - A Prospective Clinical Outcomes Study
For this study we propose to prospectively enroll musculoskeletal infection patient treated at Children's Medical Center according to the 2012 Clinical Guidelines in order to establish a musculoskeletal infection registry. The subjects will be patients of the orthopedic surgeon group at Children Medical Center who are all investigators of the proposed study. There will be at least a two year follow-up of all patients enrolled in the study either as a standard of care clinic follow-up or over phone/mail questionnaires (dependnet of diagnosis and severity of illness)
Data on the following outcomes measures will be collected:
Diagnostic characterization (specific musculoskeletal diagnoses and severity of illness score)
Vitals at admission (Temp, HR, RR, BP, WT)
Social/Health history (resident in long term care facility, dialysis, permanent in dwelling cath, prior hospitalizations espec in last 6 months, antibiotic use at admission and 6 mo. prior to admission, complete duration of symptoms with specific time frame, 'Sick Contacts/ exposures illness' including recent travel and further exposure , history of specific trauma
number of febrile days in the hospital while on antibiotics.
number of blood culture positive days.
Laboratory indices : CBC with differential, CRP, eSR, Hemoglobin, Hematocrit, Platelets
Timing of symptom onset and admission
Time between admission and definitive diagnosis.
Frequency of positive cultures from the site of infection.
Polymerase Chain Reaction (PCR) findings
Blood culture results
observance of the recommended empiric antibiotic therapy.
Rate of radiological testing.
MRi utilization and timing
number of surgeries.
Timing of initial surgery
Surgical drain type and output
Time to change to oral antibiotics.
Length of antibiotic treatment (intravenous, oral, and total)
Duration of hospital stay.
outcomes questionnaires will be completed by families during standard clinic visits for children with osteomyelitis and by mail for children who have been discharged from the clinic due to clinical and laboratory resolution of their infections. These validated questionnaires are the PoDCi (Pediatric orthopedic Data Collection instrument) at 2 year post-discharge and the PedQL (Pediatric Quality of Life) at 12 weeks post-discharge abd 2 year post-discharge.
All children of different races and ethnicity including Spanish-speaking children who are:
* birth to 18 years of age and diagnosed with musculoskeletal infection, (osteomyelitis, septic arthritis, pyomyositis, and abscesses of the spine and/or extremities).