Rechercher
image du produit
Journal of Pediatrics, The

S'abonner

Factors Associated with Surgery and Imaging Characteristics in Severe Orbital Infections - 15/09/22

Doi : 10.1016/j.jpeds.2022.05.010 
Peter J. Gill, MD, DPhil 1, 2, 3, 4, ⁎ , Olivier Drouin, MD, MPH 5, 6, 7, Catherine Pound, MD, MSc 8, Julie Quet, MD 8, Gita Wahi, MD, PhD 9, Ann Bayliss, MD 10, Gemma Vomiero, MD 11, Jessica Foulds, MD 12, Ronik Kanani, MD 13, Mahmoud Sakran, MD 14, 15, Anupam Sehgal, MD 16, Eleanor Pullenayegum, PhD 2, 17, Elysa Widjaja, MD 1, 2, Arun Reginald, MD 1, 18, Nikolaus E. Wolter, MD 1, 19, Semipe Oni, BSc 1, Rashid Anwar, MBBS, MSc 1, Jessica Cichon, HBSc, MSc 1, Hossam Louriachi, BSc 5, Yipeng Ge, MD 8, Nardin Kirolos, BSc 8, Ashaka Patel, BSc 9, Hardika Jasani, BSc 10, Emily Kornelsen, BSc 10, Ashton Chugh, BSc 11, Sandra Gouda, MD 12, Susan Akbaroghli, BSc 13, Morgyn McKerlie, BSc 16, Patricia C. Parkin, MD 1, 2, 3, 4, Sanjay Mahant, MD, MSc 1, 2, 3, 4
on behalf of Periorbital and

Orbital Cellulitis (POC) Multicenter Study Group

Canadian Pediatric Inpatient Research Network (PIRN)

1 The Hospital for Sick Children, Toronto, Ontario, Canada 
2 Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada 
3 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada 
4 Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada 
5 Department of Pediatrics, Université de Montreal, Montreal, Quebec, Canada 
6 Division of General Pediatrics, Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada 
7 Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Quebec, Canada 
8 Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada 
9 Department of Pediatrics, McMaster University, McMaster Children's Hospital, Hamilton, Ontario, Canada 
10 Trillium Health Partners, Department of Paediatrics, University of Toronto, Mississauga, Ontario, Canada 
11 Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada 
12 Department of Pediatrics, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada 
13 North York General Hospital, University of Toronto, Toronto, Ontario, Canada 
14 Department of Paediatrics, Queens University, Lakeridge Health, Oshawa, Ontario, Canada 
15 Research, Lakeridge Health, Oshawa, Ontario, Canada 
16 Kingston Health Sciences Centre, Queens University, Kingston, Ontario, Canada 
17 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada 
18 Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ontario, Canada 
19 Department of Otolaryngology, Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada 

∗Reprint requests: Peter J. Gill, MD, DPhil, Peter Gilgan Centre for Research and Learning, 686 Bay St, Toronto, Ontario M5G 0A4, Canada.Peter Gilgan Centre for Research and Learning686 Bay StTorontoOntarioM5G 0A4Canada

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.

Le texte complet de cet article est disponible en PDF.

Keywords : orbital cellulitis, periorbital cellulitis, pediatrics, observational study

Abbreviations : CRP, CT, ED, ESR, WBC


Plan


 P.G. has received grants from the Canadian Institutes of Health Research (CIHR), the Physicianss Services Incorporated Foundation, and The Hospital for Sick Children. He has received nonfinancial support from the EBMLive Steering Committee (expenses reimbursed to attend conferences) and the CIHR Institute of Human Development, Child and Youth Health (as a member of the institute advisory board, expenses reimbursed to attend meetings), is a member of the CMAJ Open and BMJ Evidence Based Medicine Editorial Board. O.D. was supported by a Chercheur Boursier Clinicien Award, from the Fonds de Recherche du Québec - Santé. The other authors declare no conflicts of interest.


© 2022  Elsevier Inc. Tous droits réservés.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

    •

  • Contenu

    •

Vol 248

P. 66 - septembre 2022 Retour au numéro
Article précédent Article précédent
  • 50 Years Ago in The Journal of Pediatrics : Respiratory Distress Syndrome Versus Cyanotic Congenital Heart Disease in Infants Who Are Newborns
  • Alan H. Jobe
| Article suivant Article suivant
  • Routine Use of Cerebral Magnetic Resonance Imaging in Infants Born Extremely Preterm
  • Julia Buchmayer, Gregor Kasprian, Vito Giordano, Victor Schmidbauer, Philipp Steinbauer, Katrin Klebermass-Schrehof, Angelika Berger, Katharina Goeral

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

Accès rapides

Mon compte

Aide & support

Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.

Tout le contenu de ce site: Copyright © 2024 Elsevier, ses concédants de licence et ses contributeurs. Tout les droits sont réservés, y compris ceux relatifs à l'exploration de textes et de données, a la formation en IA et aux technologies similaires. Pour tout contenu en libre accès, les conditions de licence Creative Commons s'appliquent.