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Objective <p>This meta-analysis aimed to synthesize factors associated with composite poor outcomes in pediatric osteomyelitis, in order to support early identification of children at risk for a more complicated clinical course and to inform future risk-stratification efforts.</p> Methods <p>The study protocol was registered on INPLASY (INPLASY202580081). We systematically searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, and Wanfang databases for studies involving patients aged 0–18&#xa0;years with osteomyelitis that reported factors or predictive variables associated with poor outcomes and provided ORs with 95% CIs. Data were analyzed using STATA, and study quality was assessed with the Newcastle–Ottawa Scale (NOS).</p> Results <p>From 6689 screened records, 20 studies were included. Factors statistically associated with composite poor outcomes included delayed source control (OR = 2.62, 95% CI 1.63–4.20, <i>P</i> &lt; 0.001), positive microbial detection (OR = 4.65, 95% CI 2.42–8.95, <i>P</i> &lt; 0.001), soft tissue abscess (OR = 5.41, 95% CI 1.70–17.24, P = 0.004), younger age (OR = 1.84, 95% CI 1.09–3.09, <i>P</i> = 0.022), fever (OR = 2.26, 95% CI 1.47–3.47, <i>P</i> &lt; 0.001), disseminated disease (OR = 4.18, 95% CI 1.78–9.82, <i>P</i> = 0.001), concurrent arthritis (OR = 3.96, 95% CI 2.67–5.87, <i>P</i> &lt; 0.001), MRSA infection (OR = 6.20, 95% CI 3.02–12.73, <i>P</i> &lt; 0.001), and elevated CRP (OR = 1.31, 95% CI 1.11–1.55, <i>P</i> = 0.002).</p> Conclusion <p>Several factors were statistically associated with composite poor outcomes in pediatric osteomyelitis. Early recognition of these factors may help clinicians identify children at risk for a more complicated clinical course and guide closer monitoring and timely intervention. These findings should be interpreted cautiously because the included studies used heterogeneous definitions of poor outcomes.</p>

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Factors associated with composite poor outcomes in pediatric osteomyelitis: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月19日

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  • Xin Jiang,
  • Tong-Tong Feng,
  • Hao-Ruo Jia,
  • Kuan Yang,
  • Ji-Ning Qu,
  • Ya-Ting Yang,
  • Qiang Jie

摘要

Objective

This meta-analysis aimed to synthesize factors associated with composite poor outcomes in pediatric osteomyelitis, in order to support early identification of children at risk for a more complicated clinical course and to inform future risk-stratification efforts.

Methods

The study protocol was registered on INPLASY (INPLASY202580081). We systematically searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, and Wanfang databases for studies involving patients aged 0–18 years with osteomyelitis that reported factors or predictive variables associated with poor outcomes and provided ORs with 95% CIs. Data were analyzed using STATA, and study quality was assessed with the Newcastle–Ottawa Scale (NOS).

Results

From 6689 screened records, 20 studies were included. Factors statistically associated with composite poor outcomes included delayed source control (OR = 2.62, 95% CI 1.63–4.20, P < 0.001), positive microbial detection (OR = 4.65, 95% CI 2.42–8.95, P < 0.001), soft tissue abscess (OR = 5.41, 95% CI 1.70–17.24, P = 0.004), younger age (OR = 1.84, 95% CI 1.09–3.09, P = 0.022), fever (OR = 2.26, 95% CI 1.47–3.47, P < 0.001), disseminated disease (OR = 4.18, 95% CI 1.78–9.82, P = 0.001), concurrent arthritis (OR = 3.96, 95% CI 2.67–5.87, P < 0.001), MRSA infection (OR = 6.20, 95% CI 3.02–12.73, P < 0.001), and elevated CRP (OR = 1.31, 95% CI 1.11–1.55, P = 0.002).

Conclusion

Several factors were statistically associated with composite poor outcomes in pediatric osteomyelitis. Early recognition of these factors may help clinicians identify children at risk for a more complicated clinical course and guide closer monitoring and timely intervention. These findings should be interpreted cautiously because the included studies used heterogeneous definitions of poor outcomes.