Department of Dermatology, Hofstra Northwell School of Medicine, New Hyde Park, New York.
Department of Dermatology, Hofstra Northwell School of Medicine, New Hyde Park, New York.
J Am Acad Dermatol. 2017 Apr;76(4):626-631. doi: 10.1016/j.jaad.2016.11.063. Epub 2017 Jan 12.
Clinicians have limited ability to classify risk of prolonged hospitalization among patients with lower limb cellulitis.
We sought to identify characteristics associated with days to discharge and prolonged stay.
We conducted retrospective cohort analysis including patients admitted with a primary diagnosis of lower limb cellulitis at community and tertiary hospitals.
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).
This analysis is retrospective and based on coded data. Unknown confounding variables may also influence prolonged stay.
Patients with lower limb cellulitis and prolonged stay have a number of clinical characteristics which may be used to classify risk for prolonged stay.
临床医生对下肢蜂窝织炎患者的住院时间延长的风险评估能力有限。
我们旨在确定与出院时间和住院时间延长相关的特征。
我们进行了回顾性队列分析,纳入了社区和三级医院因下肢蜂窝织炎初诊入院的患者。
在 3692 例患者中,共有 4224 例下肢蜂窝织炎入院。队列的平均年龄为 64.4 岁。吸烟者、肥胖者和糖尿病患者的比例分别为 25.1%、44.9%和 19.3%。不太可能出院的患者包括:年龄每增加 10 岁,出院可能性降低 0.90(95%置信区间[CI]0.88-0.92);肥胖,0.90(95%CI0.83-0.97);糖尿病,0.90(95%CI0.82-0.98);心动过速,0.76(95%CI0.67-0.85);低血压,0.77(95%CI0.65-0.90);白细胞增多症,0.86(95%CI0.79-0.93);中性粒细胞增多症,0.80(95%CI0.73-0.87);血清肌酐升高,0.74(95%CI0.68-0.81);血清碳酸氢盐降低,0.84(95%CI0.75-0.95)。
本分析为回顾性且基于编码数据。未知混杂因素也可能影响住院时间延长。
下肢蜂窝织炎且住院时间延长的患者具有许多临床特征,这些特征可用于对延长住院时间的风险进行分类。