Document Detail

Risk stratification and outcome of cellulitis admitted to hospital.
MedLine Citation:
PMID:  20346971     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To identify risk factors associated with mortality and adverse outcome of community acquired cellulitis/erysipelas requiring hospital admission. METHODS: A retrospective analysis of 395 episodes of cellulitis/erysipelas admitted to a tertiary referral hospital between January 1999 and December 2006. RESULTS: Mortality was 2.5% (10/395). There were 112 complications (28.4%). Median hospitalisation was 5 days. Factors independently associated with mortality, adverse outcome and prolonged stay (>7 days) were bacteraemia and albumin <30 g/L. A risk stratification model was designed based on factors independently associated with adverse outcome: altered mental status, neutrophilia/paenia, discharge from the cellulitic area, hypoalbuminaemia and history of congestive cardiac failure. Adverse outcome risk among patients with scores <4, 6-9 and >9 was <20%, 55% and 100%, respectively. All patients who died had admission score >or=4. Factors independently associated with prolonged hospitalisation were: age >60, symptom duration >4 days, hypoalbuminaemia, bacteraemia, isolation of MRSA and time to effective antibiotics >8 h. MRSA was more frequent among patients admitted during 2003-2006 (OR 2.43, 95% CI: 1-12-5.27). Streptococci accounted for most bacteraemia (11/20). Infectious Disease physician input was independently associated with shorter hospitalisation. CONCLUSIONS: Cellulitis/erysipelas requiring hospitalisation confers considerable morbidity and mortality. Clinical markers present on admission can be used to stratify patient risk of mortality and adverse outcome.
M Figtree; P Konecny; Z Jennings; C Goh; S A Krilis; S Miyakis
Publication Detail:
Type:  Journal Article     Date:  2010-03-25
Journal Detail:
Title:  The Journal of infection     Volume:  60     ISSN:  1532-2742     ISO Abbreviation:  J. Infect.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-31     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7908424     Medline TA:  J Infect     Country:  England    
Other Details:
Languages:  eng     Pagination:  431-9     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 The British Infection Society. All rights reserved.
Royal North Shore Hospital, Pacific Highway, St Leonards, NSW 2065, Australia.
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MeSH Terms
Bacteremia / diagnosis
Cellulitis / diagnosis*,  microbiology
Erysipelas / diagnosis
Hospitalization / statistics & numerical data
Logistic Models
Middle Aged
Reproducibility of Results
Retrospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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