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Table 1 Demographic, clinical, microbiological and therapeutic features of the patients according to the outcome

From: Factors predictive of relapse in adult bacterial osteomyelitis of long bones.

   Relapse (n = 26) No relapse (n = 90) P
Gender Male 16 (18.6%) 70 (81.4%) 0.096
Female 10 (33.3%) 20 (66.7%)
Age Years 57.42 (51.13–63.72) 51.67 (47.93–55.40) 0.14
Origin/source Hematogenous 4 (20.0%) 16 (80.0%) 0.5
Post-traumatic 12 (19.4%) 50 (80.6%)
Post-surgical 10 (29.4%) 24 (70.6%)
Bones involved Femur 6 (22.2%) 21 (77.8%) 0.9
Tibia 17 (23.6%) 55 (76.4%)
Fibula 1 (16.7%) 5 (83.3%)
Humerus 0 (0%) 3 (100%)
Ulna 1 (20.0%) 4 (80.0%)
Radius 1 (33.3%) 2 (66.7%)
Imaging (other than radiographs) Yes 20 (28.2%) 51 (71.8%) 0.06
No 6 (13.3%) 39 (86.7%)
C Reactive Protein (C-RP) mg/L 8.865 (.357–17.373) 6.440 (4.739–8.1395) 0.6
Erythrocyte sedimentation rate (ESR) mm/h 53.52 (37.26–69.78) 65.01 (57.20–72.82) 0.18
Duration of follow-up Months 56.12 (37.80–74.43) 70.28 (58.67–81.89) 0.24
Severity factors     
Relapse of previous osteomyelitis Yes 14 (28.6%) 35 (71.4%) 0.17
No 12 (17.9%) 55 (82.1%)
Symptoms longer than 3 months Yes 22 (28.6%) 55 (71.4%) 0.025
No 4 (10.3%) 35 (89.7%)
Presence of osteosynthesis material Yes 13 (22.0%) 46 (78.0%) 0.9
No 13 (22.8%) 44 (77.2%)
Bone exposure Yes 12 (26.1%) 34 (73.9%) 0.4
No 14 (20.0%) 56 (80.0%)
Vascular involvement Yes 5 (45.5%) 6 (54.5%) 0.067
No 21 (20.0%) 84 (80.0%)
Diabetes Yes 3 (30.0%) 7 (70.0%) 0.7
No 23 (21.7%) 83 (78.3%)
Multiresistant/polymicrobial infection Yes 12 (23.5%) 39 (76.5%) 0.8
No 14 (21.5%) 51 (78.5%)
Immunosuppression Yes 2 (50.0%) 2 (50.0%) 0.22
No 24 (21.4%) 88 (78.6%)
Presence of severity factors Yes 12 (29.3%) 29 (70.7%) 0.19
No 14 (18.7%) 61 (81.3%)
Types of severity factors No 14 (18.7%) 61 (81.3%) 0.4
Local 5 (22.7%) 17 (77.3%)
Systemic 4 (40.0%) 6 (60.0%)
Both 3 (33.3%) 6 (66.7%)
Number of severity factors   3.19 (2.69–3.69) 2.49 (2.2–2.76) 0.02
Microbiology     
Gram-positive cocci a Gram-positive cocci 17 (24.6%) 52 (75.4%) 0.8
Others 6 (27.3%) 16 (72.7%)
Gram-negative bacilli a Gram-negative bacilli 9 (28.1%) 23 (71.9%) 0.8
Others 15 (25.4%) 44 (74.6%)
Staphylococcus aureus a S aureus 12 (25.0%) 36 (75.0%) 0.9
Others 8 (23.5%) 26 (76.5%)
Gram-pos cocci vs Gram-neg bacilli a Gram-positive cocci 14 (25.0%) 42 (75.0%) 0.8
Gram-negative bacilli 6 (27.3%) 16 (72.7%)
Treatment
Type of treatment Antibiotics only 6 (66.7%) 3 (33.3%) 0.004
Antibiotics plus surgery 20 (18.7%) 87 (81.3%)
Intravenous beta-lactams β-lactams 5 (13.9%) 31 (86.1%) 0.7
Other antibiotics 4 (18.2%) 18 (81.8%)
Oral β-lactams β-lactams 4 (23.5%) 13 (76.5%) 0.7
Other antibiotics 9 (17.3%) 43 (82.7%)
Oral clindamycin Clindamycin 3 (10.7%) 25 (89.3%) 0.21
Other antibiotics 11 (22.0%) 39 (78.0%)
Oral rifampin Rifampin 4 (15.4%) 22 (84.6%) 0.8
Other antibiotics 10 (19.2%) 42 (80.8%)
Duration of intravenous antibiotics Days 26.44 (23.24–29.64) 29.33 (27.09–31.58) 0.21
Total duration of antibiotic treatment Days 80.76 (36.05–125.47) 69.58 (62.66–76.49) 0.40
Type of surgery None 6 (66.7%) 3 (33.3%) 0.004
Debridement 9 (19.6%) 37 (80.4%)
Debridement and flap 11 (18.0%) 50 (82.0%)
Removal of osteosynthesis material b Yes 8 (19.0%) 34 (81.0%) 0.24
No 4 (36.4%) 7 (63.6%)
Type of surgical reconstruction None 15 (27.3%) 40 (72.7%) 0.6
Free muscle flap 2 (14.3%) 12 (85.7%)
Pedicled muscle flap 4 (19.0%) 17 (81.0%)
Free fasciocutaneous flap 5 (23.8%) 16 (76.2%)
Pedicled fasciocutaneous flap/rotation 0 (0%) 5 (100%)
Surgical reconstruction Yes (all types of flaps) 11 (18.0%) 50 (82.0%) 0.23
No 15 (27.3%) 40 (72.7%)
  1. Values are expressed as mean (95% CI) or n (%) as appropriate
  2. aThe comparisons of microorganisms/antibiotics have been carried out only in the cases in which the bacteria/antibiotic have been identified
  3. bOnly in patients who had osteosynthesis material