{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:36:19Z","timestamp":1777498579912,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Children's Orthopaedics"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>A subset of children with acute haematogenous osteomyelitis become severely ill. This study aimed to define a severe and standard course and identify potential risk factors on admission for a severe course as well as the cumulative incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study included all children under 16\u2009years with acute haematogenous osteomyelitis between January 2018 and September 2021. The outcome parameters included &gt;2 surgical debridements, C-reactive protein level not halving in 48\u2009h, extraosseous involvement and hospital stay &gt;14\u2009days. Predictor variables (delayed presentation (&gt;5\u2009days), C-reactive protein &gt;250\u2009mg\/L on admission, &gt;1 bone segment and need for intensive care unit on admission) were tested against the outcome of a severe clinical course using univariate logistic regression analysis (using\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.2).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>One hundred and twenty-one patients were included. Thirty-nine patients (32.2%) had a complicated course. Patients admitted to intensive care unit had a 2.8-times higher risk of a severe course compared to those not requiring intensive care unit (risk ratio 2.8; 95% confidence interval 1.6\u20134.8); having a C-reactive protein &gt;250\u2009mg\/L on admission increased the risk of a severe course 1.7 times (risk ratio 1.71, 95% confidence interval 1.3\u20132.3). Having more than one bone segment involved and a delayed presentation of &gt;5\u2009days increased risk of a severe course by 2.4 (risk ratio 2.4, 95% confidence interval 1.6\u20133.6) and 1.3 times (risk ratio 1.3, 95% confidence interval 1.3\u20131.3)\ufeff, respectively, compared to the alternative. The cumulative incidence of acute haematogenous osteomyelitis ranged between 4.0% and 5.0% per year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Four risk factors present on admission were identified and are suggested to modify the risk of a severe disease as well as change treatment protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/18632521251346650","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T16:02:47Z","timestamp":1750780967000},"page":"301-311","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["A severe course in paediatric acute haematogenous osteomyelitis: Predictor variables present on admission"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9942-8012","authenticated-orcid":false,"given":"Mar\u00ed","family":"Thiart","sequence":"first","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6458-5189","authenticated-orcid":false,"given":"Pieter","family":"Nel","sequence":"additional","affiliation":[{"name":"Division of Microbiology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0958-5450","authenticated-orcid":false,"given":"Jacques","family":"du Toit","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2831-4960","authenticated-orcid":false,"given":"Marilize","family":"Burger","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0567-3373","authenticated-orcid":false,"given":"Nando","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Campus, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,24]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-015-1806-3"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000237"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000001635"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics9080486"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000002217"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.15077"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2015.05.012"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e32835c2b42"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa211"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000879"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0002494"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0297707"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-022-03503-y"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piab027"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e3181ab472d"},{"key":"e_1_3_3_17_2","first-page":"260","article-title":"Acute hematogenous osteomyelitis and septic arthritis in children","volume":"36","author":"Kao HC","year":"2003","unstructured":"Kao HC, Huang YC, Chiu CH, et al. 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