Does rickets carry an increased risk of osteomyelitis and septic arthritis? An aggregated electronic health record data study.
Does rickets carry an increased risk of osteomyelitis and septic arthritis? An aggregated electronic health record data study.
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佝偻病是否会增加患骨髓炎和化脓性关节炎的风险？
DOI：
10.1097/bpb.0000000000001168
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Mistovich,RJustin
中科院分区：
文献类型：
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作者：
Lavu,MonishS;VanDorn,Chloe;Bobak,Lukas;Burkhart,RobertJ;Kaelber,DavidC;Mistovich,RJustin
调查与普通人群相比，儿童佝偻病患者骨髓炎和脓毒性关节炎的患病率。使用TriNetX分析网络进行了一项回顾性队列研究，该网络汇总了来自超过1.05亿美国患者的去识别电子健康记录数据。我们根据ICD-10-CM（国际疾病分类，第十次修订，临床修改）询问了佝偻病患儿的就诊诊断。报告了任何ICD-10-CM诊断为骨髓炎或脓毒性关节炎的患者。我们建立了一个无佝偻病的儿童患者对照队列。在7337例诊断为佝偻病的儿童患者（≤ 18岁）中，96例[1.31%，95%置信区间（CI）：1.05%-1.57%]诊断为骨髓炎，28例（0.38%，95% CI：0.24%-0.52%）诊断为脓毒性关节炎。相比之下，在17 240 604例未诊断为佝偻病的儿科患者中，16 995例（0.10%，95% CI：0.10%-0.10%）诊断为骨髓炎，8521例（0.05%，95% CI：0.05%-0.05%）诊断为脓毒性关节炎。在诊断为佝偻病的儿科患者中，诊断为骨髓炎的相对风险为13.27（95%CI：10.86-16.23），而诊断为脓毒性关节炎的相对风险为7.72（95%CI：5.33-11.18）。诊断为佝偻病的儿科患者与未诊断为佝偻病的患者相比，诊断为骨髓炎和脓毒性关节炎的相对风险分别高出10倍和5倍以上。这是第一项探讨佝偻病患者肌肉骨骼感染的研究，强调了临床医生对这些疾病保持警惕的重要性。
To investigate the prevalence of osteomyelitis and septic arthritis in pediatric patients with rickets, compared to the general population. A retrospective cohort study was conducted using the TriNetX analytics network, which aggregates deidentified electronic health record data from over 105 million US patients. We queried pediatric patients with rickets, based on ICD-10-CM (International Classification of Diseases, Tenth Revision, Clinical Modification) encounter diagnoses. Patients with any ICD-10-CM encounter diagnoses of osteomyelitis or septic arthritis were reported. We established a control cohort of pediatric patients without rickets. Of 7337 pediatric patients (≤ 18 years old) with a rickets diagnosis, 96 [1.31%, 95% confidence interval (CI): 1.05%–1.57%] had a diagnosis of osteomyelitis and 28 (0.38%, 95% CI: 0.24%–0.52%) had a diagnosis of septic arthritis. In comparison, of the 17 240 604 pediatric patients without a rickets diagnosis, 16 995 (0.10%, 95% CI: 0.10%–0.10%) had a diagnosis of osteomyelitis and 8521 (0.05%, 95% CI: 0.05%–0.05%) had a diagnosis of septic arthritis. The relative risk for an osteomyelitis diagnosis in pediatric patients with a rickets diagnosis was 13.27 (95% CI: 10.86–16.23), while the relative risk for a septic arthritis diagnosis was 7.72 (95% CI: 5.33–11.18). Pediatric patients with a diagnosis of rickets have over 10-and 5-times higher relative risks for having a diagnosis of osteomyelitis and septic arthritis, respectively, compared to those without a diagnosis of rickets. This is the first study to explore musculoskeletal infections in rickets patients, highlighting the importance of clinicians being vigilant about these conditions.