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Care and outcomes of Canadian children hospitalised with periorbital and orbital cellulitis: protocol for a multicentre, retrospective cohort study

INTRODUCTION: Skin and soft tissue infections of the eye can be classified based on anatomic location as either anterior to the orbital septum (ie, periorbital cellulitis) or posterior to the orbital septum (ie, orbital cellulitis). These two conditions are often considered together in hospitalised...

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Autores principales: Gill, Peter J, Parkin, Patricia C, Begum, Nurshad, Drouin, Olivier, Foulds, Jessica, Pound, Catherine, Quet, Julie, Vomiero, Gemma, Wahi, Gita, Sakran, Mahmoud, Kozlowski, Natascha, Bayliss, Ann, Kanani, Ronik, Sehgal, Anupam, Pullenayegum, Eleanor M, Reginald, Arun, Wolter, Nikolaus, Mahant, Sanjay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937073/
https://www.ncbi.nlm.nih.gov/pubmed/31871262
http://dx.doi.org/10.1136/bmjopen-2019-035206
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author Gill, Peter J
Parkin, Patricia C
Begum, Nurshad
Drouin, Olivier
Foulds, Jessica
Pound, Catherine
Quet, Julie
Vomiero, Gemma
Wahi, Gita
Sakran, Mahmoud
Kozlowski, Natascha
Bayliss, Ann
Kanani, Ronik
Sehgal, Anupam
Pullenayegum, Eleanor M
Reginald, Arun
Wolter, Nikolaus
Mahant, Sanjay
author_facet Gill, Peter J
Parkin, Patricia C
Begum, Nurshad
Drouin, Olivier
Foulds, Jessica
Pound, Catherine
Quet, Julie
Vomiero, Gemma
Wahi, Gita
Sakran, Mahmoud
Kozlowski, Natascha
Bayliss, Ann
Kanani, Ronik
Sehgal, Anupam
Pullenayegum, Eleanor M
Reginald, Arun
Wolter, Nikolaus
Mahant, Sanjay
author_sort Gill, Peter J
collection PubMed
description INTRODUCTION: Skin and soft tissue infections of the eye can be classified based on anatomic location as either anterior to the orbital septum (ie, periorbital cellulitis) or posterior to the orbital septum (ie, orbital cellulitis). These two conditions are often considered together in hospitalised children as clinical differentiation is difficult, especially in young children. Prior studies have identified variation in management of hospitalised children with orbital cellulitis; however, they have been limited either as single centre studies or by the use of administrative data which lacks clinical details important for interpreting variation in care. We aim to describe the care and outcomes of Canadian children hospitalised with periorbital and orbital cellulitis. METHOD AND ANALYSIS: This is a multisite retrospective cohort study including previously healthy children aged 2 months to 18 years admitted to hospital with periorbital or orbital cellulitis from 2009 to 2018. Clinical data from medical records from multiple Canadian hospitals will be collected, including community and academic centres. Demographic characteristics and study outcomes will be summarised using descriptive statistics, including diagnostic testing, antibiotic therapy, adjunctive therapy, surgical intervention and clinical outcomes. Variation will be described and evaluated using χ² test or Kruskal-Wallis test. Generalised linear mixed models will be used to identify predictors of surgical intervention and longer length of stay. ETHICS AND DISSEMINATION: Approval of the study by the Research Ethics Board at each participating site has been obtained prior to data extraction. Study results will be disseminated by presentations at national and international meetings and by publications in high impact open access journals. By identifying important differences in management and outcomes by each hospital, the results will identify areas where care can be improved, practice standardised, unnecessary diagnostic imaging reduced, pharmacotherapy rationalised and where trials are needed.
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spelling pubmed-69370732020-01-06 Care and outcomes of Canadian children hospitalised with periorbital and orbital cellulitis: protocol for a multicentre, retrospective cohort study Gill, Peter J Parkin, Patricia C Begum, Nurshad Drouin, Olivier Foulds, Jessica Pound, Catherine Quet, Julie Vomiero, Gemma Wahi, Gita Sakran, Mahmoud Kozlowski, Natascha Bayliss, Ann Kanani, Ronik Sehgal, Anupam Pullenayegum, Eleanor M Reginald, Arun Wolter, Nikolaus Mahant, Sanjay BMJ Open Paediatrics INTRODUCTION: Skin and soft tissue infections of the eye can be classified based on anatomic location as either anterior to the orbital septum (ie, periorbital cellulitis) or posterior to the orbital septum (ie, orbital cellulitis). These two conditions are often considered together in hospitalised children as clinical differentiation is difficult, especially in young children. Prior studies have identified variation in management of hospitalised children with orbital cellulitis; however, they have been limited either as single centre studies or by the use of administrative data which lacks clinical details important for interpreting variation in care. We aim to describe the care and outcomes of Canadian children hospitalised with periorbital and orbital cellulitis. METHOD AND ANALYSIS: This is a multisite retrospective cohort study including previously healthy children aged 2 months to 18 years admitted to hospital with periorbital or orbital cellulitis from 2009 to 2018. Clinical data from medical records from multiple Canadian hospitals will be collected, including community and academic centres. Demographic characteristics and study outcomes will be summarised using descriptive statistics, including diagnostic testing, antibiotic therapy, adjunctive therapy, surgical intervention and clinical outcomes. Variation will be described and evaluated using χ² test or Kruskal-Wallis test. Generalised linear mixed models will be used to identify predictors of surgical intervention and longer length of stay. ETHICS AND DISSEMINATION: Approval of the study by the Research Ethics Board at each participating site has been obtained prior to data extraction. Study results will be disseminated by presentations at national and international meetings and by publications in high impact open access journals. By identifying important differences in management and outcomes by each hospital, the results will identify areas where care can be improved, practice standardised, unnecessary diagnostic imaging reduced, pharmacotherapy rationalised and where trials are needed. BMJ Publishing Group 2019-12-22 /pmc/articles/PMC6937073/ /pubmed/31871262 http://dx.doi.org/10.1136/bmjopen-2019-035206 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Paediatrics
Gill, Peter J
Parkin, Patricia C
Begum, Nurshad
Drouin, Olivier
Foulds, Jessica
Pound, Catherine
Quet, Julie
Vomiero, Gemma
Wahi, Gita
Sakran, Mahmoud
Kozlowski, Natascha
Bayliss, Ann
Kanani, Ronik
Sehgal, Anupam
Pullenayegum, Eleanor M
Reginald, Arun
Wolter, Nikolaus
Mahant, Sanjay
Care and outcomes of Canadian children hospitalised with periorbital and orbital cellulitis: protocol for a multicentre, retrospective cohort study
title Care and outcomes of Canadian children hospitalised with periorbital and orbital cellulitis: protocol for a multicentre, retrospective cohort study
title_full Care and outcomes of Canadian children hospitalised with periorbital and orbital cellulitis: protocol for a multicentre, retrospective cohort study
title_fullStr Care and outcomes of Canadian children hospitalised with periorbital and orbital cellulitis: protocol for a multicentre, retrospective cohort study
title_full_unstemmed Care and outcomes of Canadian children hospitalised with periorbital and orbital cellulitis: protocol for a multicentre, retrospective cohort study
title_short Care and outcomes of Canadian children hospitalised with periorbital and orbital cellulitis: protocol for a multicentre, retrospective cohort study
title_sort care and outcomes of canadian children hospitalised with periorbital and orbital cellulitis: protocol for a multicentre, retrospective cohort study
topic Paediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937073/
https://www.ncbi.nlm.nih.gov/pubmed/31871262
http://dx.doi.org/10.1136/bmjopen-2019-035206
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