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Topic:

Septic Arthritis

Issue:

Hip

Category:

Infection

Title:

The Price for Delayed Diagnosis of Pediatric Septic Hip: Increased Cost and Poor Outcomes

Author:

Nielsen, Ena MD; Mortimer, J. Alexandra MD, FRCSC; Bompadre, Viviana PhD; Yandow, Suzanne MD

Journal:

Journal of Pediatric Orthopaedics

Date:

November/December 2024

Reference:

44(10): p 614-618, DOI: 10.1097/BPO.0000000000002791

Level Of Evidence:

III

# of Patients:

43

Study Type:

Retrospective cohort study

Location:

Single pediatric hospital

Summary:

This study evaluates the clinical outcomes and costs associated with early versus delayed treatment of pediatric septic arthritis of the hip. The study finds that delayed diagnosis leads to worse clinical outcomes, longer hospital stays, and significantly higher healthcare costs.

Methods:

Retrospective review of hospital records from 2011 to 2016. The study compared patient demographics, clinical presentation, treatment, and follow-up data between early (within 4 days of symptoms onset) and delayed diagnosis groups. Hospital charges were calculated and compared.

Exclusions:

None specified

Results:

12 patients presented more than 4 days after symptom onset (delayed diagnosis). Significant differences were found between early and delayed diagnosis groups: Longer hospital stay (17 days vs. 9 days, P=0.003) Longer follow-up (56 weeks vs. 19 weeks, P=0.001) Increased long-term complications (50% vs. 3%, P=0.000) Longer duration of antibiotics (8 weeks vs. 5.5 weeks, P=0.043) More I&D procedures (2 vs. 1, P=0.04) More tissue cultures and blood draws (6 vs. 2, P=0.002; 3 vs. 2, P=0.009) More radiographs taken as outpatients (4 vs. 2, P=0.001) Higher average total hospital charges for delayed diagnosis group ($243,411 vs. $102,774, P=0.012).

Conclusions:

Delayed diagnosis of pediatric septic hip is associated with poorer clinical outcomes, including longer hospital stays, more complications, extended follow-up, and higher healthcare costs. Early diagnosis and treatment significantly improve both clinical outcomes and healthcare value.

Relevance:

Limitations:

Perspective:

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