2317. Multicenter Retrospective Cohort Study of Pediatric Osteomyelitis
Bibliographic record
Abstract
There is controversy about the appropriate management of acute osteomyelitis in children. Retrospective cohort study of presentation, management and outcomes of all patients admitted with acute osteomyelitis (<2 weeks duration) during 2010–2016 at 4 US and Canadian tertiary care hospitals (hosp). Long-term complications (LTC) were defined as amputation, limp, chronic or secondary infection, or readmission. Overall complications included LTC, admission to ICU and delayed surgery (>72 hours). 712 patients were admitted, with a median age of 8.0 years. There were significant differences in rates of initial use of MRI for diagnosis, MRSA, PICC insertion, hosp stay and IV antibiotic duration (Table 1). Clindamycin (45.7%), cefazolin (24.1%) and vancomycin (13.7%) were the most common IV antibiotics used while clindamycin (47.1%) and cephalexin (38.6%) predominated for oral. The median age of patients with MRSA was similar to those without MRSA (8.2 vs. 7.8 years, P = 0.18), but MSSA patients were older (9.6 vs. 6.9 years, P < 0.0001). Contiguous septic arthritis was more common in younger children (6.8 vs. 8.5 years, P < 0.001). MRSA patients had higher overall complication rates (25.2% vs. 10.0%, P < 0.0001), but long-term complications were unrelated to duration of IV or total antibiotics. Summary Results of Multi-center Study of Pediatric Osteomyelitis Despite significant variation in management, long-term complication rates were similar across US and Canadian sites with different MRSA rates. These data support equivalence of shorter (≤ 4 days) duration of IV antibiotics and reduced need for PICC insertion for pediatric osteomyelitis. All authors: No reported disclosures.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".