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Abscess volume as a predictor of surgical intervention in children hospitalized with orbital cellulitis: A multicentre cohort study.
McKerlie, Morgyn F; Wolter, Nikolaus E; Mahant, Sanjay; Cichon, Jessica; Widjaja, Elysa; Drouin, Olivier; Pound, Catherine; Quet, Julie; Wahi, Gita; Bayliss, Ann; Vomiero, Gemma; Foulds, Jessica L; Kanani, Ronik; Sakran, Mahmoud; Sehgal, Anupam; Borkhoff, Cornelia M; Pullenayegum, Eleanor; Reginald, Arun; Parkin, Patricia C; Gill, Peter J.
Afiliação
  • McKerlie MF; Queens School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
  • Wolter NE; The Hospital for Sick Children, Toronto, ON, Canada; Department of Otolaryngology, Head & Neck Surgery, University of Toronto, Toronto, ON, Canada.
  • Mahant S; The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Ca
  • Cichon J; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada.
  • Widjaja E; The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
  • Drouin O; Department of Pediatrics, Université de Montreal, Montreal, QC, Canada; Division of General Pediatrics, Department of Pediatrics, CHU Sainte-Justine, Montreal, QC, Canada; Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, QC, Canada.
  • Pound C; Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada.
  • Quet J; Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON, Canada.
  • Wahi G; Department of Pediatrics, McMaster University, McMaster Children's Hospital, Hamilton, ON, Canada.
  • Bayliss A; Trillium Health Partners, Department of Paediatrics, University of Toronto, Mississauga, ON, Canada.
  • Vomiero G; Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, AB, Canada.
  • Foulds JL; Department of Pediatrics, University of Alberta, Stollery Children's Hospital, Edmonton, AB, Canada.
  • Kanani R; North York General Hospital, University of Toronto, Toronto, ON, Canada.
  • Sakran M; Department of Paediatrics, Queens University, Lakeridge Health, Oshawa, ON, Canada; Research, Lakeridge Health, Oshawa, ON, Canada.
  • Sehgal A; Kingston Health Sciences Centre, Queen's University, Kingston, ON, Canada.
  • Borkhoff CM; The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Ca
  • Pullenayegum E; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
  • Reginald A; The Hospital for Sick Children, Toronto, ON, Canada; Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, ON, Canada.
  • Parkin PC; The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Ca
  • Gill PJ; The Hospital for Sick Children, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Ca
Int J Pediatr Otorhinolaryngol ; 171: 111629, 2023 Aug.
Article em En | MEDLINE | ID: mdl-37437497
ABSTRACT
IMPORTANCE Orbital cellulitis with subperiosteal or orbital abscess can result in serious morbidity and mortality in children. Objective volume criterion measurement on cross-sectional imaging is a useful clinical tool to identify patients with abscess who may require surgical drainage.

OBJECTIVE:

To determine the predictive value of abscess volume and the optimal volume cut-point for surgical intervention.

DESIGN:

We conducted an observational cohort study using medical records from children hospitalized between 2009 and 2018.

SETTING:

Multicentre study using data from 6 children's hospitals.

PARTICIPANTS:

Children were included if they were between 2 months and 18 years of age and hospitalized for an orbital infection with an abscess confirmed on cross-sectional imaging. EXPOSURE Subperiosteal or orbital abscess volume. MAIN OUTCOME AND

MEASURES:

The primary outcome was surgical intervention, defined as subperiosteal and/or orbital abscess drainage. Multivariable logistic regression was performed to assess the association of abscess volume with surgery. To determine the optimal abscess volume cut-point, receiver operating characteristic (ROC) analysis was performed using the Youden Index to optimize sensitivity and specificity.

RESULTS:

Of the 150 participants (mean [SD] age, 8.5 [4.5] years), 68 (45.3%) underwent surgical intervention. On multivariable analysis, larger abscess volume and non-medial abscess location were associated with surgical intervention (abscess volume adjusted odds ratio [aOR], 1.46; 95% CI, 1.11-1.93; abscess location aOR, 3.46; 95% CI, 1.4-8.58). ROC analysis demonstrated an optimal abscess volume cut-point of 1.18 mL [AUC 0.75 (95% CI 0.67-0.83) sensitivity 66%; specificity 79%]. CONCLUSIONS AND RELEVANCE In this multicentre cohort study of 150 children with subperiosteal or orbital abscess, larger abscess volume and non-medial abscess location were significant predictors of surgical intervention. Children with abscesses >1.18 mL should be considered for surgery.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doenças Orbitárias / Celulite Orbitária Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Humans Idioma: En Ano de publicação: 2023 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 / Celulite Orbitária Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article