Abstract
This retrospective
study explored the association between joint osteophytes and fever episodes,
and evaluated infection-surveillance nursing interventions in 30 patients with
joint osteophytes. Patients were divided into febrile group (n=15, with ≥1 fever
episode) and non-febrile group (n=15, no fever), with each group split into
intervention (n=8) and control (n=7) subgroups. Intervention subgroups received
infection-surveillance nursing (fever monitoring protocols, infection sign
education, timely specimen collection), while controls received routine care.
Primary outcomes included correlation between osteophyte severity (Larsen
grade) and fever incidence, and post-intervention fever recurrence rate at 3
months. Secondary outcomes included time to fever resolution, C-reactive
protein (CRP) levels, and infection-related hospitalizations. Results showed
significant positive correlation between Larsen grade and fever incidence
(r=0.63, p<0.01). Intervention subgroups had lower recurrence rates (febrile
group: 12.5% vs 57.1%; non-febrile group: 0% vs 42.9%, p<0.05).
Infection-surveillance nursing reduces fever-related risks in osteophyte
patients, particularly those with severe osteophytes.
Keywords: Osteophytes; Larsen grade; C-reactive protein; Febrile
group
Introduction
Fever in patients with
joint osteophytes is often overlooked but clinically significant, with 30-40%
of severe cases experiencing recurrent fever due to secondary joint infections
or inflammatory flares1. Osteophytes can create mechanical irritation and
tissue debris accumulation, predisposing to low-grade inflammation or infection
that presents as fever2. This study investigates the osteophyte-fever
association and evaluates targeted nursing interventions to detect and manage
febrile episodes, addressing the lack of infection-focused protocols for this
population3.
Methods
Study design and
participants
Retrospective analysis of 30 patients with
radiographically confirmed joint osteophytes (knee: 22 cases, hip: 8 cases).
Inclusion criteria: age 45-80 years; Larsen grade I-IV osteophytes; minimum
3-month follow-up. Febrile group defined as axillary temperature ≥37.5°C
lasting >24 hours with no other obvious cause. Exclusion criteria:
autoimmune diseases, malignancy, or recent systemic infections.
• Fever monitoring protocols: Twice-daily temperature recording with digital thermometers, fever diaries tracking onset, duration, and associated symptoms.
• Infection sign education: Teaching recognition of redness, swelling, and purulent discharge at osteophyte sites; linking symptoms to fever triggers.
• Timely specimen collection: Guiding proper synovial fluid and blood sampling during fever episodes for culture and sensitivity testing.
• Antimicrobial stewardship support: Ensuring compliance with prescribed antibiotics and monitoring for adverse reactions. Primary: Correlation between Larsen grade and fever incidence; 3-month fever recurrence rate. Secondary: Time to fever resolution (days), peak CRP levels (mg/L), and infection-related hospitalizations.
Statistical analysis
SPSS 26.0 used for
Pearson correlation, χ² tests, and independent t-tests. p<0.05 was
significant.
Results
Osteophyte-fever association and baseline data
Significant positive
correlation between Larsen grade and fever incidence (r=0.63, p<0.01).
Febrile group had higher initial Larsen grade and CRP (Table 1).
Table 1: Baseline
Characteristics
|
Characteristics |
Febrile Group (n=15) |
Non-Febrile Group (n=15) |
p-value |
|
Age (years, x̄±s) |
63.2±9.1 |
61.5±8.7 |
0.62 |
|
Male gender, n(%) |
9(60.0) |
8(53.3) |
0.73 |
|
Affected joint (knee/hip) |
13/2 |
9/6 |
0.18 |
|
Initial Larsen grade (x̄±s) |
2.9±0.8 |
1.7±0.6 |
<0.001 |
|
Initial CRP (mg/L, x̄±s) |
28.5±10.3 |
12.3±5.7 |
<0.001 |
|
Group |
Intervention (n=8) |
Control (n=7) |
p-value |
|
Febrile Group |
1(12.5%) |
4(57.1%) |
0.048 |
|
Non-Febrile Group |
0(0%) |
3(42.9%) |
0.047 |
Secondary outcomes
Intervention subgroups
demonstrated shorter fever resolution time, lower CRP, and fewer
hospitalizations (Table 3).
Table 3: Secondary Outcomes
|
Outcome |
Febrile Group |
Non-Febrile Group |
p-value (intervention effect) |
|
Time to resolution (days) |
Intervention:3.2±1.1 |
Intervention:0 |
0.002 |
|
|
Control:6.8±1.5 |
Control:4.3±1.2 |
- |
|
Peak CRP (mg/L) |
Intervention:35.2±8.7 |
Intervention:15.3±4.2 |
<0.001 |
|
|
Control:58.6±10.5 |
Control:32.8±7.6 |
- |
|
Hospitalizations |
Intervention:0.1±0.3 |
Intervention:0 |
0.018 |
|
|
Control:0.8±0.5 |
Control:0.5±0.5 |
- |
Discussion
This study confirms
severe joint osteophytes correlate with increased fever risk, supporting the
hypothesis that osteophyte-induced mechanical stress triggers low-grade
inflammation, and debris accumulation creates a nidus for infection4. The 2.9 Larsen
grade in the febrile group aligns with data showing osteophyte severity
elevates infection risk by disrupting joint homeostasis5.
Infection-surveillance
interventions reduced recurrence through early detection—fever diaries enabled
timely identification of patterns, while symptom education empowered patients
to report red flags [6]. Prompt specimen collection in intervention subgroups
ensured accurate microbial identification, guiding targeted antimicrobial use
and shortening resolution time7.
Notably, non-febrile
intervention subgroup avoidance of fever episodes highlights preventive value,
as osteophyte patients often have blunted immune responses masking early
infection8. Limitations include small sample size and
reliance on temperature as the sole fever marker; future studies should include
procalcitonin measurements.
Conclusion
Joint osteophyte severity
correlates significantly with fever incidence. Infection-surveillance nursing
interventions effectively reduce fever recurrence, shorten resolution time, and
decrease hospitalizations by enabling early detection and targeted management.
These strategies are critical for osteophyte patients at risk of
infection-related fever.
References
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Berendt AR, et al. Diagnosis and management of prosthetic joint infection:
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