Roda Ângela, Pinto Ana Marcos, Filipe Ana Rita, Travassos Ana Rita, Freitas João Pedro, Filipe Paulo
Serviço de Dermatologia. Hospital de Santa Maria. Centro Hospitalar Universitário Lisboa Norte. Lisboa. Portugal.
Unidade de Saúde Pública de Oeiras. Agrupamento de Centros de Saúde de Lisboa Ocidental e Oeiras. Oeiras. Portugal.
Acta Med Port. 2019 Jun 28;32(6):448-452. doi: 10.20344/amp.10735.
Cellulitis and erysipelas represent the most frequent cause of hospitalization in the dermatology department of Santa Maria Hospital in Lisbon, Portugal. The aim of this study was to investigate whether patient demographics, comorbidities, previous episodes of cellulitis/erysipelas, the presence of complications, laboratory markers at admission, microbial isolation or previous use of antibiotics, are associated with prolonged stays.
Retrospective analysis, including patients admitted with cellulitis/erysipelas in the inpatient dermatology department of Santa Maria Hospital between July 1st 2012 and June 30th 2017.
There were 372 admissions, corresponding to 348 patients. The median length of stay was 11 days. Increased age (p = 0.002, OR 1.03, 95% CI 1.01 - 1.04), previous episode of cellulitis/erysipelas requiring hospitalization (p = 0.005, OR 4.81, 95% CI 1.63 - 14.23), the presence of cellulitis/erysipelas-associated complications (p = 0.001, OR 3.28, 95% CI 1.63 - 6.59), leukocytosis (p = 0.049, OR 1.81, 95% CI 1.00 - 3.30), high levels of C-reactive protein (p = 0.035, OR 1.03, 95% CI 1.00 - 1.06) and a positive culture result (p = 0.002, OR 2.59, 95% CI 1.41 - 4.79) were associated with prolonged hospitalization.
Prolonged hospitalization for cellulitis/erysipelas is associated with higher costs, additional clinical investigation, invasive treatments, prolonged courses of antibiotic therapy, risk of nosocomial infections, and delayed return to activities of daily living. Thus, the investigation of clinical-laboratory factors associated with prolonged hospitalization for cellulitis / erysipelas is essential and may be useful for the construction of a severity score.
The knowledge of the characteristics that are associated with prolonged stay among patients with cellulitis/erysipelas may be relevant to improve health care, by reducing the length of hospital stay and associated risks and costs.
蜂窝织炎和丹毒是葡萄牙里斯本圣玛丽亚医院皮肤科住院治疗最常见的病因。本研究的目的是调查患者的人口统计学特征、合并症、既往蜂窝织炎/丹毒发作史、并发症的存在情况、入院时的实验室指标、微生物分离情况或既往抗生素使用情况是否与住院时间延长有关。
回顾性分析2012年7月1日至2017年6月30日期间在圣玛丽亚医院皮肤科住院的蜂窝织炎/丹毒患者。
共372例住院病例，涉及348名患者。中位住院时间为11天。年龄增加（p = 0.002，OR 1.03，95% CI 1.01 - 1.04）、既往因蜂窝织炎/丹毒需住院治疗（p = 0.005，OR 4.81，95% CI 1.63 - 14.23）、存在蜂窝织炎/丹毒相关并发症（p = 0.001，OR 3.28，95% CI 1.63 - 6.59）、白细胞增多（p = 0.049，OR 1.81，95% CI 1.00 - 3.30）、高C反应蛋白水平（p = 0.035，OR 1.03，95% CI 1.00 - 1.06）以及培养结果阳性（p = 0.002，OR 2.59，95% CI 1.41 - 4.79）均与住院时间延长有关。
蜂窝织炎/丹毒住院时间延长会带来更高的费用、额外的临床检查、侵入性治疗、延长抗生素治疗疗程、医院感染风险以及延迟恢复日常生活活动。因此，调查与蜂窝织炎/丹毒住院时间延长相关的临床实验室因素至关重要，可能有助于构建严重程度评分。
了解蜂窝织炎/丹毒患者中与住院时间延长相关的特征，对于通过缩短住院时间以及降低相关风险和成本来改善医疗保健可能具有重要意义。
