Clinical characteristics associated with days to discharge among patients admitted with a primary diagnosis of lower limb cellulitis

J Am Acad Dermatol. 2017 Apr;76(4):626-631. doi: 10.1016/j.jaad.2016.11.063. Epub 2017 Jan 12.

Abstract

Background: Clinicians have limited ability to classify risk of prolonged hospitalization among patients with lower limb cellulitis.

Objective: We sought to identify characteristics associated with days to discharge and prolonged stay.

Methods: We conducted retrospective cohort analysis including patients admitted with a primary diagnosis of lower limb cellulitis at community and tertiary hospitals.

Results: There were 4224 admissions for lower limb cellulitis among 3692 patients. Mean age of the cohort was 64.4 years. Frequencies of tobacco smoking, obesity, and diabetes mellitus were 25.1%, 44.9%, and 19.3%, respectively. Patients having decreased likelihood of discharge included those with the following: 10-year age increments 0.90 (95% confidence interval [CI] 0.88-0.92), obesity 0.90 (95% CI 0.83-0.97), diabetes mellitus 0.90 (95% CI 0.82-0.98), tachycardia 0.76 (95% CI 0.67-0.85), hypotension 0.77 (95% CI 0.65-0.90), leukocytosis 0.86 (95% CI 0.79-0.93), neutrophilia 0.80 (95% CI 0.73-0.87), elevated serum creatinine 0.74 (95% CI 0.68-0.81), and low serum bicarbonate 0.84 (95% CI 0.75-0.95).

Limitations: This analysis is retrospective and based on coded data. Unknown confounding variables may also influence prolonged stay.

Conclusions: Patients with lower limb cellulitis and prolonged stay have a number of clinical characteristics which may be used to classify risk for prolonged stay.

Keywords: cellulitis; discharge; length; limb; lower; prolonged; stay.

MeSH terms

  • Adult
  • Aged
  • Bicarbonates / blood
  • Cardiovascular Diseases / epidemiology
  • Cellulitis / blood
  • Cellulitis / epidemiology
  • Cellulitis / therapy*
  • Comorbidity
  • Creatinine / blood
  • Diabetes Mellitus / epidemiology
  • Female
  • Hospitals, Community
  • Humans
  • Leg
  • Length of Stay / statistics & numerical data*
  • Leukocytosis / epidemiology
  • Male
  • Middle Aged
  • Obesity / epidemiology
  • Patient Discharge
  • Retrospective Studies
  • Smoking / epidemiology
  • Tertiary Care Centers

Substances

  • Bicarbonates
  • Creatinine