WIP 110 - Prevalence of Osteoarthritic infection patients presenting with low inflammatory markers: a multi-center analysis

Poster Number: WIP 110
Publication Number: WIP 110.799

Background: Elevated inflammatory markers have long been associated with Osteoarthritic infections (OAI) and the assessment of inflammatory markers is integral to both diagnostic and management decision-making. For patients diagnosed with OAI, elevated inflammatory markers, like fever, are not present in 100% of cases, yet the actual prevalence is unknown. Understanding the prevalence of low/normal levels of inflammatory markers among OAI cases and evaluating differences in the clinical presentations associated with this subset of the population may better inform clinicians on how to best incorporate inflammatory results in their diagnostic workflow.

Objective: Assess the prevalence of low inflammatory markers in children with OAI and identify clinical elements that may be associated with a higher prevalence of OAI with low inflammatory markers.

Design/Methods: IRB-approved retrospective cross-sectional study across three hospital EDs (Connecticut Children’s Hospital, St. Louis Children’s Hospital and Boston Children’s Hospital) involving otherwise healthy children ultimately diagnosed with OAI during their hospital stay. Included are children 0-18 years of age, evaluated between October 2015 and December 2023. Cases identified with corresponding ICD10 diagnoses. Excluded are immunocompromised patients, those with chronic OAI, and co-diagnoses that may interfere with results (i.e. rheumatologic diseases) and those treated with systemic antibiotics >24 hours prior to presentation. Data collected includes demographic, history, examination, laboratory, imaging, and management variables. Natural language processing will be used for data abstraction. Statistical plan: descriptive statistics (prevalence, 95% confidence interval) to assess prevalence; and a multivariable logistic regression model with low inflammatory marker OAI cases as dependent variable and fever, bone involved, and duration as independent variables, controlling for demographics, additional laboratory studies, with robust standard errors. Final data collection and complete analytics expected by February 1, 2024.