The Joint EBJIS-MSIS 2026 Conference

PREDICTORS OF SURGICAL BURDEN IN PAEDIATRIC OSTEOMYELITIS: A MULTIVARIABLE ANALYSIS

INTRODUCTION & AIM: Surgical burden (requirement for ≥2 surgical procedures) is a indicator of severity in pediatric osteomyelitis (PO), reflecting the complexity of the infection and its treatment. This study aimed to identify independent predictors of increased surgical burden in PO.

Methods: Retrospective cohort study, with 92 childrenwith PO, analysed:

•Clinical

•Microbiological

•Variables from the BACH, Beit CURE, Cierny–Mader, and Roberts classifications.

Results:

48% of patients : ≥2 surgical procedures

Higher BACH categories were strongly associatedwith increased surgical burden (p<0.001), with BACH remained the strongest independent predictor in multivariable analysis. Compared with uncomplicated cases, patients in the complex category had significantly increased odds of multiple surgeries (OR 8), whereas those in the limited options category had markedly higher risk(OR 24).

Microbiological factors, including resistant organisms, and host-related variables were not independently associated with surgical burden.

Conclusions:

•The surgical burden in paediatric osteomyelitis is primarily driven by disease complexity

•BACH outperforms other systems in predicting the need for repeat surgery

•These findings reinforce the clinical utility of BACH

The Joint EBJIS-MSIS 2026 Conference

Predictors of Surgical Burden in Paediatric Osteomyelitis: A Multivariable Analysis

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