To establish a prospective, multicenter, real-world cohort of patients with osteomyelitis, by systematically collecting and analyzing detailed treatment and follow-up data, in order to provide clinical evidence for the standardization of its treatment
Study Design: This is a prospective, multi-center, real-world clinical study. Subjects will be assigned to different treatment regimens based on their diagnosis and differential diagnosis. Conservatively Treated Cohort: Patients with bone infection who do not meet the criteria for surgical intervention will receive conservative therapy, which includes intravenous (IV) and oral antibiotics. Surgically Treated Cohort: Patients meeting the surgical indications will undergo a staged surgical protocol. The first stage involves debridement and implantation of antibiotic-impregnated bone cement. The need for auxiliary internal or external fixation will be determined based on the patient's condition. The second stage, performed 8 weeks after the first, focuses on repairing the bone defect. All treatments will be conducted in accordance with current clinical practice guidelines. This study is purely observational; it will only monitor and collect data on changes in relevant parameters during the treatment process without interfering with any other clinical decisions. Data Collection: The following information will be recorded and collected: 1. Unique subject identifier and basic demographic information. 2. Baseline status and information prior to treatment. 3. Key information related to the surgery. 4. Post-operative follow-up information, including: (1)Pain score (Visual Analog Scale, VAS) (2)Quality of life (Short Form-36, SF-36) (3)Self-Rating Anxiety Scale (SAS) score (4)Limb function score (Disabilities of the Arm, Shoulder and Hand / Lower Extremity Functional Scale, DASH/LEFS) (5)Range of motion of adjacent joints (6)Occurrence of complications. Complications include: 1. Surgical incision complications (e.g., dehiscence, skin necrosis). 2. Pin tract infection. 3. Fixation failure or breakage. 4. Reduced joint range of motion. 5. Other discomforts deemed by the investigator to be related to the surgery. Cohort Stratification: To comprehensively describe the clinical characteristics and outcomes of bone infection, the study data will be stratified into cohorts based on the real-world treatment received by the patients. Patients will be categorized into cohorts according to the actual treatment modality they received, with each treatment type constituting a separate cohort. All cohort classifications will be performed after data collection is complete, based on predefined criteria, and will not involve proactive intervention by the investigators.
Study Type
OBSERVATIONAL
Enrollment
2,000
The First Hospital Affiliated to Army Medical University
Chongqing, Chongqing Municipality, China
Infection control rate at week 8 after treat
Patients will return for a follow-up visit at 8 weeks post-treatment. The assessment will include evaluation of the incision condition, documentation of afebrile status, and repeat laboratory tests including CBC (WBC count), ESR, and CRP
Time frame: 8 weeks after operation
Disability of Arm Shoulder and Hand Scale(DASH)
This outcome measure is applicable only to patients presenting with upper extremity symptoms or dysfunction.Patients will be guided by study staff to complete the questionnaire based on their actual condition. Disability of Arm Shoulder and Hand Scale(DASH): 1. Scoring: The total score ranges from 0 to 100. 2. Interpretation: A score of 0 indicates no disability (normal upper extremity function), while a score of 100 indicates severe disability (extremely limited upper extremity function).
Time frame: Pre-treatment; At 8 weeks post-treatment; At 12 months post-treatment
The 36-Item Short Form Health Survey
Patients will be guided by study staff to complete the questionnaire based on their actual condition. 1. Scoring: The total score ranges from 0 to 900. 2. Interpretation:The 36-Item Short Form Health Survey(SF-36)assesses health status across nine dimensions: Physical Functioning (PF), Role-Physical (RP), Bodily Pain (BP), General Health (GH), Vitality (VT), Social Functioning (SF), Role-Emotional (RE), Mental Health (MH), and Health Transition (HT). For all scales, higher scores indicate a better health status for the respondent.
Time frame: Pre-treatment; At 8 weeks post-treatment; At 12 months post-treatment
Self-Rating Anxiety Scale (SAS)
Patients will be guided by study staff to complete the questionnaire based on their actual condition. 1. Scoring: The total score ranges from 0 to 80.The standard cutoff for anxiety is a score of 50. 2. Interpretation:Mild anxiety: 50-59;Moderate anxiety: 60-69;Severe anxiety: 70 and above.
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Time frame: Pre-treatment; At 8 weeks post-treatment; At 12 months post-treatment
Pain score (assessed by Visual Analogue Scale)
Patients will be guided by study staff to complete the questionnaire based on their actual condition. 1. Scoring: The total score ranges from 0 to 10. 2. Interpretation: A score of 0 indicates "No Pain";A score of 10 indicates "The Worst Possible Pain" (or "Severe/Excruciating Pain").
Time frame: Pre-treatment;At 2 weeks post-treatment; At 8 weeks post-treatment; At 12 months post-treatment
Lower Extremity Functional Scale
This outcome measure is applicable only to patients presenting with lower extremity symptoms or dysfunction. Patients will be guided by study staff to complete the questionnaire based on their actual condition. Lower Extremity Functional Scale(LEFS): 1. Scoring: The total score ranges from 0 to 80. 2. Interpretation: A higher score indicates a higher level of lower extremity function. Conversely, a lower score indicates greater functional limitation.
Time frame: Pre-treatment; At 8 weeks post-treatment; At 12 months post-treatment