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Factors Associated with Surgery and Imaging Characteristics in Severe Orbital Infections.
Gill, Peter J; Drouin, Olivier; Pound, Catherine; Quet, Julie; Wahi, Gita; Bayliss, Ann; Vomiero, Gemma; Foulds, Jessica; Kanani, Ronik; Sakran, Mahmoud; Sehgal, Anupam; Pullenayegum, Eleanor; Widjaja, Elysa; Reginald, Arun; Wolter, Nikolaus E; Oni, Semipe; Anwar, Rashid; Cichon, Jessica; Louriachi, Hossam; Ge, Yipeng; Kirolos, Nardin; Patel, Ashaka; Jasani, Hardika; Kornelsen, Emily; Chugh, Ashton; Gouda, Sandra; Akbaroghli, Susan; McKerlie, Morgyn; Parkin, Patricia C; Mahant, Sanjay.
Afiliação
  • Gill PJ; The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, SickKids Research Institute,
  • Drouin O; Department of Pediatrics, Université de Montreal, Montreal, Quebec, Canada; Division of General Pediatrics, Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada; Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada.
  • Pound C; Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada.
  • Quet J; Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada.
  • Wahi G; Department of Pediatrics, McMaster University, McMaster Children's Hospital, Hamilton, Ontario, Canada.
  • Bayliss A; Trillium Health Partners, Department of Paediatrics, University of Toronto, Mississauga, Ontario, Canada.
  • Vomiero G; Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada.
  • Foulds J; Department of Pediatrics, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada.
  • Kanani R; North York General Hospital, University of Toronto, Toronto, Ontario, Canada.
  • Sakran M; Department of Paediatrics, Queens University, Lakeridge Health, Oshawa, Ontario, Canada; Research, Lakeridge Health, Oshawa, Ontario, Canada.
  • Sehgal A; Kingston Health Sciences Centre, Queens University, Kingston, Ontario, Canada.
  • Pullenayegum E; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
  • Widjaja E; The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
  • Reginald A; The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ontario, Canada.
  • Wolter NE; The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Otolaryngology, Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.
  • Oni S; The Hospital for Sick Children, Toronto, Ontario, Canada.
  • Anwar R; The Hospital for Sick Children, Toronto, Ontario, Canada.
  • Cichon J; The Hospital for Sick Children, Toronto, Ontario, Canada.
  • Louriachi H; Department of Pediatrics, Université de Montreal, Montreal, Quebec, Canada.
  • Ge Y; Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada.
  • Kirolos N; Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada.
  • Patel A; Department of Pediatrics, McMaster University, McMaster Children's Hospital, Hamilton, Ontario, Canada.
  • Jasani H; Trillium Health Partners, Department of Paediatrics, University of Toronto, Mississauga, Ontario, Canada.
  • Kornelsen E; Trillium Health Partners, Department of Paediatrics, University of Toronto, Mississauga, Ontario, Canada.
  • Chugh A; Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada.
  • Gouda S; Department of Pediatrics, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada.
  • Akbaroghli S; North York General Hospital, University of Toronto, Toronto, Ontario, Canada.
  • McKerlie M; Kingston Health Sciences Centre, Queens University, Kingston, Ontario, Canada.
  • Parkin PC; The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, SickKids Research Institute,
  • Mahant S; The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, SickKids Research Institute,
J Pediatr ; 248: 66-73.e7, 2022 09.
Article em En | MEDLINE | ID: mdl-35568061
ABSTRACT

OBJECTIVES:

To evaluate risk factors associated with surgical intervention and subperiosteal/orbital abscess in hospitalized children with severe orbital infections. STUDY

DESIGN:

We conducted a multicenter cohort study of children 2 months to 18 years hospitalized with periorbital or orbital cellulitis from 2009 to 2018 at 10 hospitals in Canada. Clinical details were extracted, and patients were categorized as undergoing surgical or medical-only management. Primary outcome was surgical intervention and the main secondary outcome was clinically important imaging. Logistic regression was used to identify predictors.

RESULTS:

Of 1579 patients entered, median age was 5.4 years, 409 (25.9%) had an orbital/subperiosteal abscess, and 189 (12.0%) underwent surgery. In the adjusted analysis, the risk of surgical intervention was associated with older age (age 9 to <14 aOR 3.9, 95% CI 2.3-6.6; and age 14 to ≤18 years aOR 7.0, 95% CI 3.4-14.1), elevated C-reactive protein >120 mg/L (aOR 2.8, 95% CI 1.3-5.9), elevated white blood cell count of 12-20 000/µL (aOR 1.7, 95% CI 1.1-2.6), proptosis (aOR 2.6, 95% CI 1.7-4.0), and subperiosteal/orbital abscess (aOR 5.3, 95% CI 3.6-7.9). There was no association with antibiotic use before hospital admission, sex, presence of a chronic disease, temperature greater than 38.0°C, and eye swollen shut. Complications were identified in 4.7% of patients, including vision loss (0.6%), intracranial extension (1.6%), and meningitis (0.8%).

CONCLUSIONS:

In children hospitalized with severe orbital infections, older age, elevated C-reactive protein, elevated white blood cell count, proptosis, and subperiosteal/orbital abscess were predictors of surgical intervention.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Orbitárias / Exoftalmia / Celulite Orbitária Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Orbitárias / Exoftalmia / Celulite Orbitária Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Humans Idioma: En Ano de publicação: 2022 Tipo de documento: Article