Predictive value of PAR and PNI for the acute complicated course of pediatric acute hematogenous osteomyelitis

Chaochen Zhao; Zhiye Guan; Qizhi Jiang; Wangqiang Wu; Xiaodong Wang

doi:10.1016/j.jped.2024.04.002

Predictive value of PAR and PNI for the acute complicated course of pediatric acute hematogenous osteomyelitis

J Pediatr (Rio J). 2024 Apr 25:S0021-7557(24)00046-9. doi: 10.1016/j.jped.2024.04.002. Online ahead of print.

Authors

Chaochen Zhao¹, Zhiye Guan², Qizhi Jiang¹, Wangqiang Wu¹, Xiaodong Wang³

Affiliations

¹ Children's Hospital of Soochow University, Department of Orthopaedics, Suzhou, Jiangsu Province, China.
² Shanghai Jiao Tong University, School of Medicine, Shanghai Children's Hospital, Department of Orthopaedics, Shanghai, China.
³ Children's Hospital of Soochow University, Department of Orthopaedics, Suzhou, Jiangsu Province, China. Electronic address: wangxd@suda.edu.cn.

PMID: 38677322
DOI: 10.1016/j.jped.2024.04.002

Abstract

Objective: Platelet to albumin ratio (PAR) and prognostic nutritional index (PNI) are potential indicators for evaluating nutritional and inflammatory status. This study aimed to examine the relationship between PAR and PNI and the acute complicated course of acute hematogenous osteomyelitis (AHO).

Methods: AHO patients were divided into the simple course group and the acute complicated course group. The patient's gender, age, site of infection, body temperature, laboratory results, and pathogen culture results were collected and compared. Multivariate logistic regression analysis was used to determine the independent risk factors of the acute complicated course group. The receiver operating characteristic curve was applied to determine the optimal cut-off value.

Results: In total, 101 AHO patients with a median age of 7.58 years were included. There were 63 cases (62.4 %) in the simple course group and 38 cases (37.6 %) in the complicated course group. Binary logistic regression analysis revealed that PAR and PNI were independent risk factors for predicting the acute complicated course of AHO (p = 0.004 and p < 0.001, respectively). Receiver operating characteristic curve analysis demonstrated that the combination of PAR and PNI had an area under the curve of 0.777 (95 % CI: 0.680-0.873, p < 0.001) with a cut-off value of 0.51.

Conclusions: The incidence of acute complicated courses was significantly higher in patients with high PAR and low PNI. A combined factor greater than 0.51, derived from PAR and PNI measurements within 24 h of admission, may be useful for predicting AHO patients who are likely to develop severe disease.

Keywords: Acute hematogenous osteomyelitis; Complication; Platelet to albumin ratio; Prognostic nutritional index.