Harvard Medical School, Boston, Massachusetts.
Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts.
JAMA Dermatol. 2019 Jun 1;155(6):720-723. doi: 10.1001/jamadermatol.2018.4650.
Cellulitis commonly results in hospitalization. Limited data on the proportion of cellulitis admissions associated with readmission are available.
To characterize the US national readmission rate associated with hospitalization for treatment of cellulitis.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort analysis of cellulitis admissions from the nationally representative 2014 Nationwide Readmissions Database calculated readmission rates for all cellulitis admissions and subsets of admissions. The multicenter population-based cohort included adult patients admitted for conditions other than obstetrical or newborn care. Data were collected from January 1 through November 30, 2014, and analyzed from February 1 through September 18, 2018. Bivariate logistic regression models were used to assess differences in readmission rates by patient characteristics. Costs were calculated for all readmissions after discharge from hospitalization for cellulitis (hereinafter referred to as cellulitis discharge) and by readmission diagnosis.
Admission with a primary diagnosis of cellulitis.
Proportion of cellulitis admissions associated with nonelective readmission within 30 days, characteristics of patients readmitted after cellulitis discharge, and costs associated with cellulitis readmission.
A total of 447 080 (95% CI, 429 927-464 233) index admissions with a primary diagnosis of cellulitis (53.8% male [95% CI, 53.5%-54.2%]; mean [SD] age, 56.1 [18.9] years) were included. Overall 30-day all-cause nonelective readmission rate after cellulitis discharge was 9.8% (95% CI, 9.6%-10.0%). Among patients with cellulitis, age (odds ratio for 45-64 years, 0.78; 95% CI, 0.75-0.81; P = .001) and insurance status (odds ratio for Medicare, 2.45; 95% CI, 2.33-2.58; P < .001) were associated with increased readmission rates. The most common diagnosis of readmissions included skin and subcutaneous tissue infections. The total cost associated with nonelective readmissions attributed to skin and subcutaneous infections within 30 days of a cellulitis discharge during the study period was $114.4 million (95% CI, $106.8-$122.0 million).
Readmission after hospitalization for cellulitis is common and costly and may be preventable with improved diagnostics, therapeutics, and discharge care coordination.
蜂窝织炎通常会导致住院。有关与蜂窝织炎住院相关的再入院比例的有限数据。
描述与治疗蜂窝织炎相关的美国全国再入院率。
设计、地点和参与者：这项回顾性队列分析来自全国代表性的 2014 年全国再入院数据库的蜂窝织炎入院数据，计算了所有蜂窝织炎入院和入院亚组的再入院率。该多中心基于人群的队列纳入了因除产科或新生儿护理以外的其他疾病而入院的成年患者。数据收集自 2014 年 1 月 1 日至 11 月 30 日，分析于 2018 年 2 月 1 日至 9 月 18 日进行。采用双变量逻辑回归模型评估患者特征对再入院率的差异。计算了所有出院后（以下简称蜂窝织炎出院）和再入院诊断的蜂窝织炎再入院的费用。
以蜂窝织炎为主要诊断的入院。
蜂窝织炎入院中与 30 天内非选择性再入院相关的比例、蜂窝织炎出院后再入院患者的特征以及与蜂窝织炎再入院相关的费用。
共纳入 447080 例（95%CI，429927-464233）蜂窝织炎主要诊断指数入院（53.8%为男性[95%CI，53.5%-54.2%]；平均[SD]年龄，56.1[18.9]岁）。蜂窝织炎出院后 30 天内所有原因非选择性再入院率总体为 9.8%（95%CI，9.6%-10.0%）。在蜂窝织炎患者中，年龄（45-64 岁的比值比为 0.78；95%CI，0.75-0.81；P=.001）和保险状况（医疗保险的比值比为 2.45；95%CI，2.33-2.58；P<.001）与再入院率增加相关。再入院的最常见诊断包括皮肤和皮下组织感染。在研究期间，蜂窝织炎出院后 30 天内与皮肤和皮下组织感染相关的非选择性再入院的总费用为 11.44 亿美元（95%CI，10.68-12.20 亿美元）。
蜂窝织炎住院后再入院很常见且费用高昂，通过改进诊断、治疗和出院护理协调，可能可以预防这种情况。
