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Factors associated with readmission and mortality in adult patients with skin and soft tissue infections
被引:14
作者:
Raya-Cruz, Manuel
[1
]
Payeras-Cifre, Antonio
[1
]
Ventayol-Aguilo, Lola
[1
]
Diaz-Antolin, Paz
[2
]
机构:
[1] Son Llatzer Hosp, Internal Med & Infect Dis, Balearic Isl, Spain
[2] Son Llatzer Hosp, Clin Microbiol Dept, Balearic Isl, Spain
关键词:
ACUTE BACTERIAL SKIN;
HOSPITALIZED-PATIENTS;
COMPLICATED SKIN;
RISK-FACTORS;
EPIDEMIOLOGY;
CELLULITIS;
DIAGNOSIS;
MANAGEMENT;
DISEASES;
D O I:
10.1111/ijd.14390
中图分类号:
R75 [皮肤病学与性病学];
学科分类号:
100206 ;
摘要:
Background Skin and soft tissue infections (SSTIs) are a common cause of consultation, and complicated cases require hospitalization. We describe factors that are related to readmission and/or mortality of hospitalized patients diagnosed with SSTIs. Methods Retrospective review of hospital-admitted patients with a diagnosis of cellulitis, abscess, hidradenitis, fasciitis, and Fournier's gangrene. Cases from January 2002 to October 2015 were extracted from the diagnostic codification database of the Archives and Clinical Documentation Department. Findings We studied 1,482 episodes of hospitalized patients diagnosed with SSTIs. There were 187 (12.3%) readmissions, the most frequent diagnosis was cellulitis (72.7%), and the most commonly isolated microorganism was Staphylococcus aureus (25; 30.1%). Factors associated with readmissions were healthcare-related infections (P = 0.002), prior antibiotic therapy (P < 0.001), ischemic heart disease (P = 0.01), chronic liver disease (P = 0.001), and diabetes mellitus (DM) (P = 0.006). The number of patients who died as a result of an infection was 34 (2.2%) and, in these patients, the most common diagnosis was also cellulitis (79.4%), which in 52.9% (P = 0.001) was community acquired. DM (P = 0.01), heart failure (P = 0.001), and chronic liver disease (P = 0.003) were the most frequent comorbidities. This group presented more complications (P < 0.005) such as endocarditis (P < 0.005), amputation (P = 0.018), severe sepsis (P < 0.005), and septic shock (P < 0.001). Conclusions Readmitted patients had healthcare-related S. aureus infection, had received prior antibiotic therapy, and presented comorbid conditions such as ischemic heart disease, peripheral vascular disease, chronic liver disease, or DM. Comorbidities such as advanced age, DM, heart failure, and chronic liver disease were associated with complications and higher infection-related mortality.
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页码:916 / 924
页数:9
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