The design, characteristics and predictors of mortality in the North of England Cellulitis Treatment Assessment (NECTA).
OBJECTIVE
Cellulitis is a common cause of acute medical admissions in UK hospitals. The factors that determine susceptibility to an acute admission or to mortality following hospital admission are poorly defined.


METHODS
We studied a retrospective cohort of 568 patients with a diagnosis of cellulitis between 1 January 2001 and 31 December 2003 in the north-east of England to see whether we could determine these factors. We collected data on the factors that were associated with acute hospital admissions and survival. We used a primary end-point of deaths within 1 year of admission for cellulitis.


RESULTS
The characteristics that identified patients at high risk of mortality were present in 39.9% of the cohort studied. The four most common of these characteristics were lower limb oedema 30.1% (95% CI: -26.0 to 34.1), ulceration 24% (95% CI: -20.2 to 27.8), previous myocardial infarction (MI) 19.9% (95% CI: -16.3 to 23.4) and blunt injury 18.7% (95% CI: -15.3 to 22.2). Significant predictors of mortality were: patient's age (p < 0.001), presence of penetrating injury (p < 0.001), previous MI (p < 0.001), presence of liver disease (p = 0.003), presence of lower limb oedema (p = 0.01) and long-term use of drugs that caused sodium and water retention (p < 0.001). Treatment with i.v. flucloxacillin was found to be a significant predictor of survival (odds ratio = 3.43, z =3.42. p < 0.001) at 360 days.


CONCLUSIONS
Our results show that cellulitis as a cause of an acute medical admission may present with a variety of clinical features. Some of these clinical features can be used to predict mortality within 360 days of an acute hospital admission.
Tan
R
R
Department of Medicine for the Elderly, Addenbrookes Hospital, Cambridge, UK.
Newberry
D J
DJ
Arts
G J
GJ
Onwuamaegbu
M E
ME
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002481:Cellulitis / Q000188:drug therapy / Q000401:mortality*; D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D005260:Female; D005436:Floxacillin / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010400:Penicillin G / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors
D000900:Anti-Bacterial Agents; D005436:Floxacillin; D010400:Penicillin G