Department of Orthopaedic Surgery, Waikato Hospital, Hamilton.
Department of Surgery, University of Auckland, Grafton, Auckland, New Zealand.
J Pediatr Orthop B. 2023 Sep 1;32(5):490-496. doi: 10.1097/BPB.0000000000001033. Epub 2022 Nov 14.
Acute haematogenous osteomyelitis (AHO) remains a cause of severe illness among children with the possibility of long-term consequences for growth and development. Previous research on sequelae from AHO rarely considers outcomes more than 2 years following treatment. This study aims to establish the quality of life of patients diagnosed with AHO in childhood up to 13 years after diagnosis, evaluating the impact on social, emotional, physical, and school function. Children treated for AHO between 2008 and 2018 at a tertiary referral centre in New Zealand were identified. Paediatric Quality of Life Inventory (PedsQL) questionnaires were conducted via phone with either the child or primary caregiver and responses analysed. Forty patients met inclusion criteria, were contactable by phone, and consented to participate. The mean age was 7 years (range 0-15) and most were female (60%). Health-related quality of life (HRQOL) was scored as a percentage with most participants scoring >80% ( n = 27). Those who do experience reduced quality of life following treatment for AHO were likely to complain of pain, stiffness, or anxiety. The impact of significant childhood illness on mental health was not adequately captured by the PedsQL but was highlighted in qualitative feedback. The majority of children treated for AHO reported excellent HRQOL up to 13 years following treatment although a negative impact on mental health was reported using qualitative analysis. A refined scoring system is needed to assess the long-term impact of musculoskeletal infection. Patient case series, Level IV.
急性血源性骨髓炎（AHO）仍然是导致儿童重病的原因，有可能对生长和发育造成长期影响。以前关于 AHO 后遗症的研究很少考虑治疗后超过 2 年的结果。本研究旨在确定儿童期诊断为 AHO 的患者在诊断后 13 年内的生活质量，评估其对社交、情感、身体和学校功能的影响。在新西兰的一家三级转诊中心，对 2008 年至 2018 年期间接受 AHO 治疗的儿童进行了研究。通过电话对儿童或主要照顾者进行了儿童生活质量调查问卷（PedsQL）调查，并对回答进行了分析。符合纳入标准的 40 名患者可通过电话联系，并同意参与。平均年龄为 7 岁（范围 0-15 岁），大多数为女性（60%）。健康相关生活质量（HRQOL）以百分比评分，大多数参与者的评分>80%（n=27）。那些在治疗 AHO 后经历生活质量下降的人可能会抱怨疼痛、僵硬或焦虑。尽管在定性反馈中强调了，但 PedsQL 并未充分捕捉到重大儿童疾病对心理健康的影响。大多数接受 AHO 治疗的儿童在治疗后 13 年内报告了极佳的 HRQOL，但使用定性分析报告了对心理健康的负面影响。需要一种更精细的评分系统来评估肌肉骨骼感染的长期影响。患者病例系列，四级。
